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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2026; 17(2): 115615
Published online Feb 18, 2026. doi: 10.5312/wjo.v17.i2.115615
Published online Feb 18, 2026. doi: 10.5312/wjo.v17.i2.115615
Cemented vs uncemented femoral fixation in total hip arthroplasty: A systematic review and meta-analysis of periprosthetic fracture risk
Mohammed H Abushal, Department of Orthopedic Surgery, University of Tabuk, Tabuk 71491, Saudi Arabia
Osama M Embaby, Department of Orthopedic Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B66 2QT, United Kingdom
Mahmoud Mersal, Department of Orthopedic Surgery, University Hospital of Birmingham Foundation Trust, Birmingham B9 5SS, United Kingdom
Emran Badghish, Department of Surgery, College of Medicine, University of Bisha, Bisha 67714, Saudi Arabia
Mohamed Elalfy, Department of Orthopedic Surgery, Mansoura University, Mansoura 35516, Egypt
Co-first authors: Mohammed H Abushal and Osama M Embaby.
Author contributions: Abushal MH and Embaby OM designed the study concept and methodology they contributed equally to this article, they are the co-first authors of this manuscript; Abushal MH, Embaby OM, and Mersal M conducted the clinical investigation and data collection; Embaby OM and Mersal M performed data curation; drafted original manuscript; Abushal MH, Embaby OM, Mersal M, Badghish E, and Elalfy M subsequently reviewed and edited; and all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed H Abushal, Assistant Professor, Department of Orthopedic Surgery, University of Tabuk, Duba Road, University City, Tabuk 71491, Saudi Arabia.
Received: October 21, 2025
Revised: November 4, 2025
Accepted: December 16, 2025
Published online: February 18, 2026
Processing time: 106 Days and 12.6 Hours
Revised: November 4, 2025
Accepted: December 16, 2025
Published online: February 18, 2026
Processing time: 106 Days and 12.6 Hours
Core Tip
Core Tip: This article evaluated the effect of cemented vs uncemented femoral fixation in primary total hip arthroplasty on the risk of periprosthetic femoral fracture. Twenty-seven studies were reviewed, and three provided comparative data for quantitative analysis. The findings showed a non-significant trend toward fewer periprosthetic femoral fractures with cemented fixation but high heterogeneity among studies. These results highlight the need for individualized fixation choice in total hip arthroplasty and underscore the importance of high-quality prospective research to clarify optimal fixation strategies.