Clin Orthop Surg.  2017 Jun;9(2):145-152. 10.4055/cios.2017.9.2.145.

Comparison of Postoperative Infection-Related Complications between Cemented and Cementless Hemiarthroplasty in Elderly Patients: A Meta-Analysis

• Yoon BH
• Seo JG
• Koo KH

• KMID: 2412281
• DOI: http://doi.org/10.4055/cios.2017.9.2.145

Abstract

BACKGROUND
The purpose of this review was to assess the risk of infection-related complications following cemented and cementless hemiarthroplasty in elderly patients.
METHODS
We searched PubMed, EMBASE, and Cochrane Library databases for published randomized clinical trials comparing cemented hemiarthroplasty with cementless hemiarthroplasty in patients with a femoral neck fracture and more than 65 years of age. Eight randomized controlled trials were available for analysis. A meta-analysis (with a fixed-effects model) and a meta-regression analysis (with continuous variables) were performed.
RESULTS
The 8 trials included 1,204 hips (608 cemented and 596 cementless). There was no significant difference between the cemented and cementless groups regarding the incidence of deep infection, superficial infection, pneumonia, and urinary tract infection. The overall incidence of postoperative deep infection was 2.3% (14/608) in the cemented group and 1.2% (7/596) in the cementless group (relative risk, 1.74; 95% confidence interval, 0.74 to 4.14; I² = 0%; p = 0.206). No publication bias was found in the funnel plot.
CONCLUSIONS
Results of our meta-analysis suggest that when selecting a fixation method for hemiarthroplasty, infection-related postoperative complications are not the determinant factor to consider.

Keyword

Infection; Intraoperative complications; Hemiarthroplasty; Meta-analysis

MeSH Terms

Aged
Aged, 80 and over
Bacterial Infections/*epidemiology
Bone Cements/*therapeutic use
*Hemiarthroplasty/adverse effects/statistics & numerical data
Humans
Postoperative Complications/*epidemiology
Bone Cements

Figure

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  Fig. 1 Flow diagram of relevant clinical study selection.

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  Fig. 2 Forest plot of the odds ratios with confidence intervals for deep infection. Two of the 8 studies reporting no cases of deep infection were excluded in this analysis. CI: confidence interval.

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  Fig. 3 Forest plot of the odds ratios with confidence intervals (CIs) for postoperative infection-related complications. (A) Superficial wound infection. (B) Pneumonia. (C) Urinary tract infection.

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  Fig. 4 Funnel plot for postoperative infection-related complications.

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  Fig. 5 The summary of bias risk of randomized controlled trials.

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