Cemented vs uncemented hip hemiarthroplasty in medial femoral neck fractures in the elderly: the Association of Orthopaedic Traumatology of Italian Hospitals (OTODI) Multicenter Study
Abstract
Background. The choice between cemented and uncemented hip hemiarthroplasty for medial femoral neck fractures in the elderly remains debated. While international guidelines often recommend cementation, modern uncemented designs offer potential advantages in operative efficiency.
Methods. This OTODI (Orthopaedic Traumatology of Italian Hospitals)-coordinated, prospective multicenter study analyzed 1,417 patients over 75 years of age across 150 Italian centers. Clinical trends, operative parameters, and mid-term outcomes (up to 12 months) were compared between cemented and uncemented fixation.
Results. Uncemented fixation was predominant (65.6%). The uncemented group showed significantly shorter mean operative times (62.0 vs. 72.8 minutes; p < 0.0001) and better initial functional scores (Barthel Index; p = 0.046). No significant differences were found in intraoperative complications, 12-month mortality, or long-term functional recovery.
Conclusions. In Italian clinical practice, modern uncemented hip hemiarthroplasty are frequently utilized and provide comparable safety and efficacy to cemented stems. These findings support the use of modern uncemented designs as a reliable alternative that reduces operative time without compromising mid-term outcomes.
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© © Ortopedici Traumatologi Ospedalieri d’Italia (O.T.O.D.i.) , 2026
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