February 2007 issue of the SICOT newsletter (No. 103)

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EvidencebasedorthopaedicsArthroplasties with and without bonecement for proximal femoral fracturesin adultsBackground: Numerous types of arthroplasties maybe used in the surgical treatment of a hip fracture(proximal femoral fracture). The main differencesbetween the implants are in the design of the stems,whether the stem is fixed in place with or withoutcement, whether a second articulating joint is includedwithin the prosthesis (bipolar prosthesis) or whethera partial (hemiarthroplasty) or total whole hipreplacement is used.Objectives: To review all randomised controlledtrials that have compared different arthroplasties forthe treatment of hip fractures in adults.Search strategy: We searched the Cochrane Bone,Joint and Muscle Trauma Group Specialised Register(December 2005), the Cochrane Central Registerof Controlled Trials (The Cochrane Library Issue 4,2005), MEDLINE, EMBASE and the UK NationalResearch Register.Selection criteria: All randomised and quasi-randomisedcontrolled trials comparing differentarthroplasties and their insertion with or withoutcement for the treatment of hip fractures.Data collection and analysis: Two review authorsindependently assessed trial quality, by use of a tenitemchecklist, and extracted data.Main results: Seventeen trials involving 1,920patients were included. One trial involved two comparisons.Cementedprostheses,when compared withuncemented (six trials, 549 participants), were associatedwith less pain a year later (16/52 versus 28/52;RR 0.51, 95% CI 0.31 to 0.81) and a tendency tobetter mobility. No significant difference in surgicalcomplications was found.A comparison of unipolarhemiarthroplasty with bipolar hemiarthroplasty(seven trials, 857 participants, 863 fractures) showedno significant differences between the two types ofimplant.Two trials involving 232 patients compareduncemented hemiarthroplasty with a total hip replacement.Both studies reported increased pain forthe uncemented prosthesis and one study foundbetter mobility and a lower long-term revision ratefor those treated with a THR.Two trials involving214 participants compared cemented hemiarthroplastyversus total hip replacement. Both trials generallyfound little difference between prostheses.THR was associated with a slightly longer surgicaltime but a tendency to better functional outcome inone trial.Authors' conclusions: There is limited evidencethat cementing a prosthesis in place may reduce postoperativepain and lead to better mobility.There isinsufficient evidence to determine the roles ofbipolar prostheses and total hip replacement.Furtherwell-conducted randomised trials are required.Citation: Parker MJ, Gurusamy K.Arthroplasties (with and without bone cement)for proximal femoral fractures in adults(Cochrane Review).The Cochrane Database of Systematic Reviews 2006,Issue 3.■page 2
The SICOT Newsletter:a steady communication toolEditorialLast August, the 100th edition of the Newsletter was distributedto all SICOT members throughout the world.The first issue ofthe Newsletter was published in October 1985 and its initialfunction was to remedy the lack of communication between membersduring the long three-year period between the World Congresses.Theadvent of the electronic era and the development of the SICOT Portalon the Web markedly changed the way we keep in contact and worktogether. However, the Newsletter remains the most direct and effectivetool of communication for our Society.The look of the Newsletterchanged over time following to some extent the same trends ofcontemporary periodicals. In recent years, improvements in the designand contents including the Evidence based orthopaedics section, theCountry to country series of the National Delegates, the AnnualReports of the Committees, and the Young surgeons section enliventhe Newsletter. This is the combined result of a joint effort by the EditorialOffice, and the members of the Publication and CommunicationsCommittee.Accordingly, the content of the Newsletters reflects theprogress of our Society and records its main events.Thus, it is a vitalchronicle of the most recent history of SICOT.I would like to thank the staff at the Headquarters in Brussels for thededication and commitment to the Newsletter.There is some good news also from the Board of International Orthopaedics:the number of papers submitted for peer-review is steadilyincreasing.At this stage, there are more than 100 accepted paperswaiting for publication. From now on, the peer-review work will beeven more selective; subsequently, the overall scientific quality of thepublished papers will increase, and this will foster the impact of theJournal. I extend my compliments to the Editor and the members ofthe Editorial Board.Rocco P. PittoEditorial Secretarypage 3
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February 2007 issue of the SICOT newsletter (No. 103)

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