15.7Review protocol – Cement

Review questionIn hip fracture patients undergoing total hip replacement what is the clinical and cost effectiveness of cemented total hip replacement versus uncemented total hip replacement on mortality, surgical revision, functional status, length of stay, quality of life, pain and place of residence after hip fracture?
ObjectivesTo examine the effectiveness of cement when inserting arthroplasty for surgical repair
PopulationPatients >18 years old with a hip fracture undergoing surgical repair

People with fractures caused by specific pathologies other than osteoporosis or osteopaenia, and patients under 18 years old are excluded from the scope.
InterventionCemented arthroplasty
ComparisonUncemented arthroplasty

Perioperative mortality

Mortality at 30 days, 3 months & 1 year or longer

Functional status up to 1 year

Pain (generally measured by visual analogue scale or verbal rating)

Quality of life

Requirement for reoperation

Length of stay in hospital/acute care

Length of stay in to community or resettlement (i.e. superspell)

Place of residence 12 months after fracture

Wound healing complications

Search strategyThe databases to be searched are Medline, Embase, The Cochrane Library, CINAHL and AMED.

Randomised controlled trials (RCTs) will be considered.

No date restriction will be applied. Databases will be searched from their date of origin

All questions relating to surgical repair for hip fractures will be searched together.
The review strategyMeta-analyses will be conducted where possible.

Studies will be restricted to English language articles

If there is heterogeneity the following subgroups will be analysed separately:



Ideally “younger and fitter” patients compared to the “older and frailer” patients. Could be a combination of age and comorbidities

Type of arthroplasty

From: Appendix C, Review protocols

Cover of The Management of Hip Fracture in Adults
The Management of Hip Fracture in Adults [Internet].
NICE Clinical Guidelines, No. 124.
National Clinical Guideline Centre (UK).
Copyright © 2011, National Clinical Guideline Centre.

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