Comparison of infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture: a Meta-analysis of randomized controlled studies_West China Medical Journal

Authors：

 LIU Kai , WANG Yongcai , WANG Hongchuan , JIANG Junwei

Department of Orthopedics, People's Hosipital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding author：

LIU Kai, Email: 285061643@qq.com

Keywords：

Cemented; Cementless; Hemiarthroplasty; Elderly patients with femoral neck fracture; Meta-analysis

DOI：

10.7507/1002-0179.201802059

Video：

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ObjectiveTo systematically review the postoperative infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture.MethodsCochrane Library, PubMed, Embase, China Biology Medicine Database, Chongqing VIP China Science and Technology Journal Database, China National Knowledge Infrastructure, and Wanfang Database were searched to collect randomized controlled trials of postoperative infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture from inception to January 2018. A systematic review was performed to compare the postoperative deep infection, superficial wound infection, pneumonia infection, and urinary tract infection between cemented and cementless hemiarthroplasty. Analyses were conducted using Review Manager version 5.2.0 software.ResultsA total of 11 studies were included in the Meta-analysis, including 1 533 patients. There was no significant difference in the incidence of deep infection [odds ratio (OR)=1.62, 95% confidence interval (CI) (0.66, 3.94), P=0.29], superficial wound infection [OR=1.17, 95%CI (0.56, 2.47), P=0.68], pneumonia infection [OR=0.73, 95%CI (0.47, 1.13), P=0.16], or urinary tract infection [OR=1.10, 95%CI (0.65, 1.86), P=0.73] between the two groups.ConclusionWhen selecting a fixation method for hemiarthroplasty to treat eldly patients with femoral neck fracture, infection-related postoperative complications are not the determinant factor to consider.

Citation： LIU Kai, WANG Yongcai, WANG Hongchuan, JIANG Junwei. Comparison of infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture: a Meta-analysis of randomized controlled studies. West China Medical Journal, 2018, 33(9): 1118-1123. doi: 10.7507/1002-0179.201802059 Copy

1.	Gjertsen JE, Vinje T, Engesaeter LB, et al. Internal screw fixation compared with bipolar hemiarthroplasty for treatment of displaced femoral neck fractures in elderly patients. J Bone Joint Surg Am, 2010, 92(3): 619-628.
2.	Husted H, Otte KS, Kristensen BB, et al. Low risk of thromboembolic complications after fast-track hip and knee arthroplasty. Acta Orthop, 2010, 81(5): 599-605.
3.	Yurdakul E, Karaaslan F, Korkmaz M, et al. Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients?. Clin Interv Aging, 2015, 10: 1063-1067.
4.	李涛, 王英振, 李玉龙, 等. 骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折安全性的 Meta 分析. 中华老年骨科与康复电子杂志, 2017, 3(2): 109-115.
5.	魏志辉, 赵波, 何超, 等. 骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折的 Meta 分析. 中国矫形外科杂志, 2016, 24(14): 1287-1294.
6.	Sonne-Holm S, Walter S, Jensen JS. Moore hemi-arthroplasty with and without bone cement in femoral neck fractures. A clinical controlled trial. Acta Orthop Scand, 1982, 53(6): 953-956.
7.	Emery RJ, Broughton NS, Desai K, et al. Bipolar hemiarthroplasty for subcapital fracture of the femoral neck. A prospective randomised trial of cemented Thompson and uncemented Moore stems. J Bone Joint Surg Br, 1991, 73(2): 322-324.
8.	Santini S, Rebeccato A, Bolgan I, et al. Hip fractures in elderly patients treated with bipolar hemiarthroplasty: comparison between cemented and cementless implants. J Orthop Traumatol, 2005, 6(2): 80-87.
9.	Parker MI, Pryor G, Gurusamy K. Cemented versus uncemented hemiarthroplasty for intracapsular hip fractures: a randomised controlled trial in 400 patients. J Bone Joint Surg Br, 2010, 92(1): 116-122.
10.	Deangelis JP, Ademi A, Staff I, et al. Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: a prospective randomized trial with early follow-up. J Orthop Trauma, 2012, 26(3): 135-140.
11.	Taylor F, Wright M, Zhu M. Hemiarthroplasty of the hip with and without cement: a randomized clinical trial. J Bone Joint Surg Am, 2012, 94A(7): 577-583.
12.	Vidovic D, Matejcic A, Punda M, et al. Periprosthetic bone loss following hemiarthroplasty: a comparison between cemented and cementless hip prosthesis. Injury, 2013, 44(Suppl 3): S62-S66.
13.	Moerman S, Mathijssen NMC, Niesten DD, et al. More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up. BMC Musculoskelet Disord, 2017, 18(1): 169.
14.	孟海亮, 王坤正, 王春生, 等. 骨水泥与非骨水泥双动头假体治疗老年股骨颈骨折的比较. 中国组织工程研究, 2009, 13(22): 4231-4236.
15.	高玉镭, 田敏, 王东辰, 等. 骨水泥和非骨水泥型人工股骨双动头置换的临床疗效分析. 中国矫形外科杂志, 2013, 21(6): 571-574.
16.	潘沈淇. 骨水泥型和非骨水泥型半髋关节置换术治疗移位股骨颈骨折的疗效比较. 中国医师进修杂志, 2013, 36(17): 41-43.
17.	Yli-Kyyny T, Sund R, Heinänen M, et al. Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures?. Acta Orthop, 2014, 85(1): 49-53.
18.	Yoon BH, Ha YC, Lee YK, et al. Postoperative deep infection after cemented versus cementless total hip arthroplasty: a meta-analysis. J Arthroplasty, 2015, 30(10): 1823-1827.
19.	Wang F, Zhang H, Zhang Z, et al. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord, 2015, 16(1): 229.

1. Gjertsen JE, Vinje T, Engesaeter LB, et al. Internal screw fixation compared with bipolar hemiarthroplasty for treatment of displaced femoral neck fractures in elderly patients. J Bone Joint Surg Am, 2010, 92(3): 619-628.
2. Husted H, Otte KS, Kristensen BB, et al. Low risk of thromboembolic complications after fast-track hip and knee arthroplasty. Acta Orthop, 2010, 81(5): 599-605.
3. Yurdakul E, Karaaslan F, Korkmaz M, et al. Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients?. Clin Interv Aging, 2015, 10: 1063-1067.
4. 李涛, 王英振, 李玉龙, 等. 骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折安全性的 Meta 分析. 中华老年骨科与康复电子杂志, 2017, 3(2): 109-115.
5. 魏志辉, 赵波, 何超, 等. 骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折的 Meta 分析. 中国矫形外科杂志, 2016, 24(14): 1287-1294.
6. Sonne-Holm S, Walter S, Jensen JS. Moore hemi-arthroplasty with and without bone cement in femoral neck fractures. A clinical controlled trial. Acta Orthop Scand, 1982, 53(6): 953-956.
7. Emery RJ, Broughton NS, Desai K, et al. Bipolar hemiarthroplasty for subcapital fracture of the femoral neck. A prospective randomised trial of cemented Thompson and uncemented Moore stems. J Bone Joint Surg Br, 1991, 73(2): 322-324.
8. Santini S, Rebeccato A, Bolgan I, et al. Hip fractures in elderly patients treated with bipolar hemiarthroplasty: comparison between cemented and cementless implants. J Orthop Traumatol, 2005, 6(2): 80-87.
9. Parker MI, Pryor G, Gurusamy K. Cemented versus uncemented hemiarthroplasty for intracapsular hip fractures: a randomised controlled trial in 400 patients. J Bone Joint Surg Br, 2010, 92(1): 116-122.
10. Deangelis JP, Ademi A, Staff I, et al. Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: a prospective randomized trial with early follow-up. J Orthop Trauma, 2012, 26(3): 135-140.
11. Taylor F, Wright M, Zhu M. Hemiarthroplasty of the hip with and without cement: a randomized clinical trial. J Bone Joint Surg Am, 2012, 94A(7): 577-583.
12. Vidovic D, Matejcic A, Punda M, et al. Periprosthetic bone loss following hemiarthroplasty: a comparison between cemented and cementless hip prosthesis. Injury, 2013, 44(Suppl 3): S62-S66.
13. Moerman S, Mathijssen NMC, Niesten DD, et al. More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up. BMC Musculoskelet Disord, 2017, 18(1): 169.
14. 孟海亮, 王坤正, 王春生, 等. 骨水泥与非骨水泥双动头假体治疗老年股骨颈骨折的比较. 中国组织工程研究, 2009, 13(22): 4231-4236.
15. 高玉镭, 田敏, 王东辰, 等. 骨水泥和非骨水泥型人工股骨双动头置换的临床疗效分析. 中国矫形外科杂志, 2013, 21(6): 571-574.
16. 潘沈淇. 骨水泥型和非骨水泥型半髋关节置换术治疗移位股骨颈骨折的疗效比较. 中国医师进修杂志, 2013, 36(17): 41-43.
17. Yli-Kyyny T, Sund R, Heinänen M, et al. Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures?. Acta Orthop, 2014, 85(1): 49-53.
18. Yoon BH, Ha YC, Lee YK, et al. Postoperative deep infection after cemented versus cementless total hip arthroplasty: a meta-analysis. J Arthroplasty, 2015, 30(10): 1823-1827.
19. Wang F, Zhang H, Zhang Z, et al. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord, 2015, 16(1): 229.

West China Medical Journal

Comparison of infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture: a Meta-analysis of randomized controlled studies

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