Using data from the Norwegian Hip Fracture Register,
8639 cemented and 2477 uncemented primary hemiarthroplasties for
displaced fractures of the femoral neck in patients aged > 70 years
were included in a prospective observational study. A total of 218
re-operations were performed after cemented and 128 after uncemented
procedures. Survival of the hemiarthroplasties was calculated using
the Kaplan-Meier method and hazard rate ratios (HRR) for revision
were calculated using Cox regression analyses. At five years the
implant survival was 97% (95% confidence interval (CI) 97 to 97)
for cemented and 91% (95% CI 87 to 94) for uncemented hemiarthroplasties.
Uncemented hemiarthroplasties had a 2.1 times increased risk of
revision compared with cemented prostheses (95% confidence interval
1.7 to 2.6, p < 0.001). The increased risk was mainly caused
by revisions for peri-prosthetic fracture (HRR = 17), aseptic loosening
(HRR = 17), haematoma formation (HRR = 5.3), superficial infection
(HRR = 4.6) and dislocation (HRR = 1.8). More intra-operative complications,
including intra-operative death, were reported for the cemented
hemiarthroplasties. However, in a time-dependent analysis, the HRR
for re-operation in both groups increased as follow-up increased. This study showed that the risk for revision was higher for uncemented
than for cemented hemiarthroplasties.