To cement or not in hip fracture surgery?

1·3 million hip fractures occurred globally in 1990, with predictions of numbers rising to anywhere between 7·3 and 21·3 million by 2050.

Mortality after a hip fracture remains substantial, being 11–23% at 6 months and increasing to 22–29% at 12 months after the injury.

Total hip replacement and hemiarthroplasty are the main treatment options for displaced femoral neck fractures, with broadly similar outcomes for both procedures. What is less clear, however, is whether these arthroplasties should be cemented, uncemented, or hybrid. Although to some extent an old debate, this issue has attracted renewed interest of late because of the possible risk of the potentially catastrophic bone-cement implantation syndrome in those who have undergone cementing procedures.