Background Hemiarthroplasty and total hip arthroplasty (TKA) are commonly used to treat unstable femoral neck fractures in older patients. However, there is no consensus on the use of cement during hemiarthroplasty and TKA. Previous reviews on this subject included small number of studies and lacked evidence grading of outcomes. In this study, we aimed to compare the outcomes of cemented and uncemented arthroplasty for the treatment of femoral neck fractures in older patients. Methods A meta-analysis was conducted according to the guidelines of the Cochrane Collaboration using online databases (Pubmed, Cochrane Central Register of Controlled Trials, and Ovid). The quality of the included studies was assessed using the Cochrane Collaboration tool and Newcastle-Ottawa Scale. Prospective cohort studies and randomized controlled trials (RCT) of cemented arthroplasty versus uncemented arthroplasty for treatment of femoral neck fractures were analyzed using Review Manager (version 5.2) software. Results Sixteen studies were included in the meta-analysis. Cemented arthroplasty was found to be superior to uncemented arthroplasty with respect to reoperation rate, complications related to prosthesis, residual pain, and operation time. There were no significant between-group differences with respect to local and general complications, duration of hospital stay, hip function, and mortality. Conclusion Compared with cemented arthroplasty, uncemented arthroplasty was associated with a greater risk of complications related to prosthesis, reoperation rate, residual pain, and longer operation time. However, the results of this meta-analysis should be interpreted cautiously owing to some limitations. Further studies are required to provide more robust evidence.
Background Developmental dysplasia of the hip (DDH) is a common disease in infants and children, and the treatment of bilateral DDH remains controversial. This study aimed to evaluate the stability of one-stage bilateral Salter pelvic osteotomy for bilateral DDH in patients of walking age. Methods In total, nine child cadavers aged 2–6 years were included. A universal mechanical testing machine was used for stability test. We performed two different surgical procedures on the specimens: nine child cadavers underwent unilateral Salter pelvic osteotomy, and six child cadavers were randomly selected to undergo Salter pelvic osteotomy again to simulate one-stage bilateral Salter pelvic osteotomy. The stability of the bilateral sacroiliac joints, local stability of the operation area, ultimate load test, and axial stiffness were evaluated. Results Both unilateral and bilateral Salter osteotomy could destroy the integrity of the pelvic ring and increase the risk of pelvic instability. In this study, compared with unilateral Salter osteotomy, bilateral Salter osteotomy had similar pelvic stability, and there was no significant difference between unilateral and bilateral Salter osteotomy in sacroiliac joint stability ( p > 0.05), local stability ( p = 0.763), ultimate load ( p = 0.328), and axial stiffness ( p = 0.480). Conclusions One-stage bilateral Salter pelvic osteotomy as a potential surgical method is viable and stable for children with bilateral DDH.
Background Developmental dysplasia of the hip (DDH) is a common disease in infants and children, and the treatment of bilateral DDH remains controversial. This study aimed to evaluate the stability of one-stage bilateral Salter pelvic osteotomy for bilateral DDH in patients of walking age. Methods In total, nine child cadavers aged 2–6 years were included. A universal mechanical testing machine was used for stability test. We performed two different surgical procedures on the specimens: nine child cadavers underwent unilateral Salter pelvic osteotomy, and six child cadavers were randomly selected to undergo Salter pelvic osteotomy again to simulate one-stage bilateral Salter pelvic osteotomy. The stability of the bilateral sacroiliac joints, local stability of the operation area, ultimate load test, and axial stiffness were evaluated. Results Both unilateral and bilateral Salter osteotomy could destroy the integrity of the pelvic ring and increase the risk of pelvic instability. In this study, compared with unilateral Salter osteotomy, bilateral Salter osteotomy had similar pelvic stability, and there was no significant difference between unilateral and bilateral Salter osteotomy in sacroiliac joint stability ( p > 0.05), local stability ( p = 0.763), ultimate load ( p = 0.328), and axial stiffness ( p = 0.480). Conclusions One-stage bilateral Salter pelvic osteotomy as a potential surgical method is viable and stable for children with bilateral DDH.
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