Moderate evidence supports the preferential use of cemented femoral stems in patients undergoing arthroplasty for femoral neck fractures.

Rationale
Eight moderate strength (Deangelis et al 84, Figved et al 85, Taylor et al 86,Santini et al87, Lennox et al88, Parker et al 89, Sonne-Holm et al 90, Singh et al 91) studies address the question of cemented or press fit arthroplasty in the elderly. Randomized controlled trials have largely failed to demonstrate differences (Deangelis et al 84, Figved et al 85), with the exception of fracture risk, which appears to be higher in press fit stems (Taylor et al 86). This remains an infrequent event in other studies.  In general, both approaches yielded acceptable functional results with low complication rates.

Risks and Harms of Implementing this Recommendation
As with all surgical procedures, there are potential risks and benefits which are unlikely to be affected by this recommendation.

Future Research
Long term studies designed specifically to elucidate potential differences in postoperative fracture risk between cemented or press fit stems are needed.
 
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