ArticleJournal of orthopaedic surgery and research2025
Cemented versus cementless cup fixation in total hip arthroplasty for proximal femoral fractures: analysis of revision and mortality rates from the German arthroplasty registry (EPRD).
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Comparison of Cemented Versus Cementless Total Hip Arthroplasty in Elderly Patients: A Prospective Cohort Study.Journal of orthopaedic case reports · 2026Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of femoral neck fractures (FNF) in elderly patients depends on comorbidities, pre-fracture mobility, any hip joint disease, and life expectancy, with treatment typically involving either hemiarthroplasty (HA) or total hip arthroplasty (THA). While cemented femoral stem fixation is standard, there is no clear consensus regarding cemented versus cementless cup fixation in THA. This study aimed to compare revision and mortality rates between THA, divided into cemented and cementless cup fixation, and HA, following FNF.
methodsData from the German Arthroplasty Registry (EPRD) were analyzed, including all patients with fracture-related THA or HA and available follow-up. A total of 34,501 patients undergoing THA (27,757 cementless, 6,744 cemented cups) and 72,022 patients with HA were included. 5-year revision and mortality rates were compared.
resultsThe 5-year revision rate was the lowest in the HA group (4.1%), followed by cemented cup THA (5.0%), and cementless cup THA (6.8%; p < 0.001). Dislocation, infection, and periprosthetic fracture were the leading causes of revision. The 5-year mortality rate was the lowest in cementless cup THA patients (23%), 43% in cemented cup THA patients and highest in HA patients (54%). Cementless fixation was associated with a higher revision risk (HR 1.28, 95% CI 1.14-1.44), while HA was associated with increased mortality (HR 1.26, 95% CI 1.22-1.31).
conclusionCemented cup fixation in THA after FNF is associated with lower revision rates but higher mortality compared to cementless fixation. In patients with limited life expectancy, HA remains the preferred option.
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