Hemiarthroplasty for Femoral Neck Fractures in the Elderly: A Comparison of Cemented and Uncemented Femoral Stems.

JBJS Rev · Jul 2020 · Review

DeRogatis MJ, Piatek AZ, Jacob R, Kelly SC, Issack PS

New York-Presbyterian Hospital, New York, NY

Orthopaedic Trauma Adult Reconstruction

SUMMARY — THE REDUCTIONFor elderly patients with displaced femoral neck fractures, uncemented hemiarthroplasty appears to offer function and mortality equivalent to cemented stems, with shorter operative time and less embolization risk but more intraoperative periprosthetic fracture.
Abstract, as published

The incidence of displaced femoral neck fractures among elderly patients is increasing as the population ages.Historically, the preferred treatment for displaced femoral neck fractures in elderly patients has been hemiarthroplasty with use of cemented fixation of the implant. However, there is evidence that this technique may be associated with fat embolization and subsequent cardiopulmonary arrest in the early postoperative period. Cementing techniques are also associated with increased operative time when compared with cementless techniques.There is increasing evidence that, among elderly patients, the use of uncemented hemiarthroplasty has equivalent functional outcomes and overall mortality rates when compared with the use of hemiarthroplasty with cemented fixation. The main complication associated with uncemented hemiarthroplasty is intraoperative periprosthetic fracture.

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