Cemented Versus Uncemented Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients

Background: Fracture of the femoral neck is a common injury in the elderly population and is associated with significant morbidity and functional disability. Hemiarthroplasty is widely used for the management of displaced femoral neck fractures. However, the choice between cemented and uncemented hemiarthroplasty remains controversial.

Objective: To compare the clinical outcomes, operative parameters, complications, and functional results of cemented versus uncemented hemiarthroplasty in elderly patients with femoral neck fractures.

Materials and Methods: This prospective comparative study was conducted in the Department of Orthopaedics at Smt. NHL Municipal Medical College from January 2023 to December 2025. A total of 60 elderly patients (≥60 years) with displaced femoral neck fractures treated with hemiarthroplasty were included. Patients were divided into two groups: Group A (cemented hemiarthroplasty, n=30) and Group B (uncemented hemiarthroplasty, n=30). Patients were evaluated for operative time, intraoperative blood loss, postoperative complications, duration of hospital stay, and functional outcome using the Harris Hip Score (HHS) during follow-up.

Results: The mean operative time and intraoperative blood loss were higher in the cemented group (90 ± 10 minutes and 320 ± 50 ml) compared to the uncemented group (75 ± 8 minutes and 260 ± 40 ml). Complication rates were comparable between the groups, although periprosthetic fractures were slightly more common in the uncemented group. Functional outcomes assessed by Harris Hip Score were better in the cemented group, with a mean HHS of 86.5 ± 7 compared to 82.3 ± 8 in the uncemented group.

Conclusion: Both cemented and uncemented hemiarthroplasty are effective treatment options for femoral neck fractures in elderly patients. Cemented hemiarthroplasty demonstrated slightly better functional outcomes, whereas uncemented hemiarthroplasty had shorter operative time and less intraoperative blood loss.