Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients

Abstract

Background: Femoral neck fractures are common in elderly patients, and
hemiarthroplasty is a preferred surgical treatment. However, the choice between
cemented and uncemented hemiarthroplasty remains a topic of debate. This study
aims to compare intraoperative parameters, functional outcomes, and complications
of cemented versus uncemented hemiarthroplasty.
Methods: This prospective observational study was conducted over six months at
Vardhman Mahavir Medical College and Safdarjung Hospital, enrolling 50 patients
(≥60 years) with displaced femoral neck fractures. Patients were equally divided into
cemented (n=25) and uncemented (n=25) hemiarthroplasty groups. Intraoperative
parameters, functional outcomes (Harris Hip Score, Timed Up, and Go test), and
postoperative complications were assessed over a six-month follow-up. Statistical
analysis was performed using independent t-tests and chi-square tests, with a
significance level of p<0.05.
Results: Cemented hemiarthroplasty had a significantly longer surgery duration
(75.3 ± 10.5 vs. 63.8 ± 8.2 minutes; p=0.002) and greater blood loss (320 ± 50 vs.
210 ± 45 mL; p=0.001). The Harris Hip Score at six months was slightly higher in
the cemented group (81.5 ± 6.2 vs. 78.3 ± 7.1; p=0.12), and the Timed Up and Go
test indicated better mobility (14.2 ± 2.3 vs. 16.1 ± 2.8 seconds; p=0.04).
Periprosthetic fractures were more frequent in the uncemented group (12% vs. 4%;
p=0.28). Overall complication rates were comparable between the two groups
(p=0.53).
Conclusion: Cemented hemiarthroplasty resulted in better early functional outcomes
and lower periprosthetic fracture rates but was associated with longer surgical time
and increased blood loss. Uncemented hemiarthroplasty may be preferable for
patients with cardiovascular risks due to the avoidance of bone cement implantation
syndrome. Further long-term studies are required to confirm these findings and
optimize patient selection.