Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients

Int Orthop. 2013 Jun;37(6):1135-40. doi: 10.1007/s00264-013-1851-3. Epub 2013 Mar 19.


Purpose: Adverse events associated with the use of bone cement for fixation of prostheses is a known complication. Due to inconclusive results in studies of hip fracture patients treated with cemented and uncemented hemiprostheses, this study was initiated.

Methods: Our study is based on data reported to the Norwegian Hip Fracture Register on 11,210 cervical hip fractures treated with hemiprostheses (8,674 cemented and 2,536 uncemented).

Results: Significantly increased mortality within the first day of surgery was found in the cemented group (relative risk 2.9, 95 % confidence interval 1.6-5.1, p=0.001). The finding was robust giving the same results after adjusting for independent risk factors such as age, sex, cognitive impairment and comorbidity [American Society of Anesthesiologists (ASA) score]. For the first post-operative day the number needed to harm was 116 (one death for every 116 cemented prosthesis). However, in the most comorbid group (ASA worse than 3), the number needed to harm was only 33.

Conclusions: We found increased mortality for the cemented hemiprosthesis the first post-operative day compared to uncemented procedures. This increased risk is closely related to patient comorbidity estimated by the patient's ASA score.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / methods*
  • Bone Cements*
  • Female
  • Hip Fractures / mortality*
  • Hip Fractures / surgery*
  • Hip Prosthesis*
  • Hospital Mortality
  • Humans
  • Male
  • Norway
  • Perioperative Period*
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome


  • Bone Cements