The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
ABSTRACT Objective Femoral neck fractures in the elderly are a global health issue, with the choice between cemented and uncemented hemiarthroplasty remaining a topic of debate. This systematic review and meta‐analysis aims to compare the effects of the two surgical options on health‐related quality...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.14339 |
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| author | Mohanad Samaheen Maen Mohammad Mikhail Salzmann Nikolai Ramadanov |
| author_facet | Mohanad Samaheen Maen Mohammad Mikhail Salzmann Nikolai Ramadanov |
| author_sort | Mohanad Samaheen |
| collection | DOAJ |
| description | ABSTRACT Objective Femoral neck fractures in the elderly are a global health issue, with the choice between cemented and uncemented hemiarthroplasty remaining a topic of debate. This systematic review and meta‐analysis aims to compare the effects of the two surgical options on health‐related quality of life (HRQoL), mortality, and functional outcomes. Methods We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing cemented with uncemented hemiarthroplasty in patients aged 50 years and older with femoral neck fractures. The primary outcome of interest was HRQoL as measured by the European Quality of Life 5‐Dimension Questionnaire (EQ‐5D) score. Secondary outcomes included mortality, surgical, general, and local complications. Results We included 20 RCTs with a total of 3680 patients with femoral neck fractures, of whom 1871 (50.5%) underwent cemented and 1809 (49.5%) uncemented hemiarthroplasty. The follow‐up ranged from 1 to 6 years. The early (after 3–4 months) EQ‐5D utility score (MD 0.07; 95% CI 0.03–0.12; p = 0.003; I 2 = 22%) and the 12‐month EQ‐5D utility score (MD 0.08; 95% CI 0.00–0.16; p = 0.04; I 2 = 67%) suggested an improved HRQoL in the cemented hemiarthroplasty group. The outcomes of 1‐year mortality, requirement for additional surgeries, surgery duration, risk of pulmonary embolism, pressure sores or ulcers, intraoperative fractures, and periprosthetic or postoperative fractures demonstrated significant differences between the two groups. Conclusions The use of cemented hemiarthroplasty in patients with femoral neck fractures presented better results when compared to uncemented hemiarthroplasty in terms of HRQoL during the first year after surgery and greater mortality reduction at 1 year follow‐up and reduced the need for further surgery. Therefore, the use of cemented hemiarthroplasty may be preferred for the treatment of femoral neck fractures in elderly patients. |
| format | Article |
| id | doaj-art-656b40e279b34def9bdfb283fb54144e |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-656b40e279b34def9bdfb283fb54144e2025-02-03T03:10:59ZengWileyOrthopaedic Surgery1757-78531757-78612025-02-0117236137210.1111/os.14339The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled TrialsMohanad Samaheen0Maen Mohammad1Mikhail Salzmann2Nikolai Ramadanov3Faculty of Medicine Al‐Quds University Jerusalem PalestineFaculty of Medicine Al‐Quds University Jerusalem PalestineMedical School Brandenburg Theodor Fontane University Hospital Brandenburg Brandenburg an der Havel GermanyMedical School Brandenburg Theodor Fontane University Hospital Brandenburg Brandenburg an der Havel GermanyABSTRACT Objective Femoral neck fractures in the elderly are a global health issue, with the choice between cemented and uncemented hemiarthroplasty remaining a topic of debate. This systematic review and meta‐analysis aims to compare the effects of the two surgical options on health‐related quality of life (HRQoL), mortality, and functional outcomes. Methods We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing cemented with uncemented hemiarthroplasty in patients aged 50 years and older with femoral neck fractures. The primary outcome of interest was HRQoL as measured by the European Quality of Life 5‐Dimension Questionnaire (EQ‐5D) score. Secondary outcomes included mortality, surgical, general, and local complications. Results We included 20 RCTs with a total of 3680 patients with femoral neck fractures, of whom 1871 (50.5%) underwent cemented and 1809 (49.5%) uncemented hemiarthroplasty. The follow‐up ranged from 1 to 6 years. The early (after 3–4 months) EQ‐5D utility score (MD 0.07; 95% CI 0.03–0.12; p = 0.003; I 2 = 22%) and the 12‐month EQ‐5D utility score (MD 0.08; 95% CI 0.00–0.16; p = 0.04; I 2 = 67%) suggested an improved HRQoL in the cemented hemiarthroplasty group. The outcomes of 1‐year mortality, requirement for additional surgeries, surgery duration, risk of pulmonary embolism, pressure sores or ulcers, intraoperative fractures, and periprosthetic or postoperative fractures demonstrated significant differences between the two groups. Conclusions The use of cemented hemiarthroplasty in patients with femoral neck fractures presented better results when compared to uncemented hemiarthroplasty in terms of HRQoL during the first year after surgery and greater mortality reduction at 1 year follow‐up and reduced the need for further surgery. Therefore, the use of cemented hemiarthroplasty may be preferred for the treatment of femoral neck fractures in elderly patients.https://doi.org/10.1111/os.14339cementedhealth‐related quality of lifehemiarthroplastyhip fracturesuncemented |
| spellingShingle | Mohanad Samaheen Maen Mohammad Mikhail Salzmann Nikolai Ramadanov The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials Orthopaedic Surgery cemented health‐related quality of life hemiarthroplasty hip fractures uncemented |
| title | The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_full | The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_fullStr | The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_full_unstemmed | The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_short | The Health‐Related Quality of Life for Cemented Versus Uncemented Hemiarthroplasty in Elderly Patients With Femoral Neck Fractures: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_sort | health related quality of life for cemented versus uncemented hemiarthroplasty in elderly patients with femoral neck fractures a systematic review and meta analysis of randomized controlled trials |
| topic | cemented health‐related quality of life hemiarthroplasty hip fractures uncemented |
| url | https://doi.org/10.1111/os.14339 |
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