A Comparative Study of Clinical and Functional Outcomes of Cemented Versus Uncemented Hemiarthroplasty in Patients with Displaced Fractures of the Neck of Femur

Abstract

Background: Displaced fractures of the neck of the femur are common among elderly individuals and are associated with significant morbidity, functional disability, and reduced quality of life. Hemiarthroplasty is a widely accepted treatment; however, the choice between cemented and uncemented fixation remains debated. Aim: To compare the clinical and functional outcomes of cemented versus uncemented hemiarthroplasty in patients with displaced fractures of the neck of the femur. Materials and Methods: This prospective comparative observational study included 60 patients with displaced femoral neck fractures, divided into two groups: cemented hemiarthroplasty (n = 30) and uncemented hemiarthroplasty (n = 30). Operative parameters, postoperative pain, mobilization, complications, and functional outcomes using the Harris Hip Score (HHS) were assessed over six months. Results: Mean age was comparable between the cemented and uncemented groups (71.8 ± 7.6 versus 70.9 ± 8.2 years). Operative duration (92.6 versus 78.3 minutes; p<0.001) and blood loss (285.4 versus 242.6 mL; p = 0.009) were significantly higher in the cemented group. However, cemented hemiarthroplasty demonstrated earlier mobilization (2.4 versus 3.1 days; p = 0.007), lower six-month VAS pain scores (0.9 versus 1.5; p<0.001), and higher six-month HHS (86.4 versus 81.2; p = 0.007). Periprosthetic fractures and implant subsidence were more frequent in the uncemented group. Conclusion: Cemented hemiarthroplasty demonstrated better pain relief, earlier mobilization, and improved functional outcomes, whereas uncemented fixation reduced operative duration and blood loss. Cemented fixation may be preferable in appropriately selected elderly patients.

Keywords: Cemented hemiarthroplasty; Uncemented hemiarthroplasty; Femoral neck fracture; Harris Hip Score; Functional outcomes; Postoperative complications.