***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background It is unclear whether cemented or uncemented hemiarthroplasty is the best treatment option in elderly patients with displaced femoral neck fractures . Previous r and omized trials comparing cemented and uncemented hemiarthroplasty have conflicting results . We conducted a r and omized controlled trial to compare cemented and uncemented hemiarthroplasty . Methods This multicenter parallel-r and omized controlled trial included patients of 70 years and older with a displaced femoral neck fracture ( Garden type III or IV ) . Inclusion was between August 2008 and June 2012 . Patients were r and omized between a cemented hemiarthroplasty , type Müller Straight Stem or an uncemented hemiarthroplasty , type DB-10 . Primary outcomes were complications , operation time , functional outcome ( measured by Timed-Up- and -Go ( TUG ) and Groningen Activity Restriction Scale ( GARS ) ) and mid-thigh pain . Health Related Quality of Life ( HRQoL , expressed with the SF-12 ) was measured as an secondary outcome . Follow up was 1 year . Results In total 201 patients were included in the study ( 91 uncemented  , 110 cemented hemiarthroplasties ) The uncemented group showed more major local complications ( intra- and postoperative fractures and dislocations ) odds ratio ( 95 % confidence interval ) 3.36 ( 1.40 to 8.11 ) . There was no difference in mean operation time ( 57.3 vs 55.4 min ) . There were no differences in functional outcomes ( TUG 12.8 ( 9.4 ) vs. 13.9 ( 9.0 ) , GARS 43.2 ( 19.7 ) vs. 39.2 ( 16.5 ) ) and mid-thigh pain ( 18.6 vs 21.6 % ) . Physical component SF-12 HRQoLwas lower in the uncemented group ( 30.3 vs. 35.3 p < 0.05 after six weeks , 33.8 vs 38.5 p < 0.05 after 12 weeks ) . Conclusion A cemented hemiarthroplasty in elderly patients with a displaced femoral neck fracture results in less complications compared to an uncemented hemiarthroplasty . Trial registration Netherl and s Trial Registry ; NTR 1508 , accepted date 27 okt Objective : To prospect ively compare the functional outcome associated with cemented and uncemented hemiarthroplasty . Design : Prospect i ve r and omized control trial . Setting : University-affiliated level 1 trauma center . Patients / Participants : All individuals design ated for hemiarthroplasty , older than 55 years , with a nonpathologic displaced femoral neck fracture and the ability to ambulate 10 feet independently before injury [ 269 patients ( 274 hips ) presented with displaced femoral neck fracture , 130 patients ( 48.3 % ) enrolled , and 5 patients ( 3.8 % ) withdrew ] . Intervention : Hip hemiarthroplasty with a cemented femoral prosthesis ( VerSys LD/Fx ; Zimmer , Warsaw , IN ) or an uncemented component ( VerSys Beaded FullCoat ; Zimmer , Warsaw , IN ) . Main Outcome Measures : Instrumental Activities of Daily Living and Physical Activities of Daily Living scales ( Older Americans Re sources and Services Instrument ) and the Energy/Fatigue Scale . Results : No statistically significant differences were present in the groups ' preoperative or intraoperative characteristics , including American Society of Anesthesiologists grade , operative time , anesthesia time , use of perioperative & bgr;-blockers , estimated blood loss , or the rate of intraoperative fracture . Postoperatively , no difference was found in hemoglobin level , transfusion rate , discharge disposition , or acute complication rate . At 30-day , 60-day , and 1-year follow-ups , no clinical ly or statistically significant differences were found in mortality , disposition , need for assistance with ambulation , Older Americans Re sources and Services Activities of Daily Living subscales , or the Energy/Fatigue Scale . Conclusions : In the treatment of nonpathologic displaced femoral neck fractures , the use of cemented and uncemented femoral components is associated with similar functional outcome at 1 year . Practitioners may inform their clinical decisions using these equally good results . Level of Evidence : Therapeutic Level II . See page 128 for a complete description of levels of evidence Background Displaced femoral neck fractures usually are treated with hemiarthroplasty . However , the degree to which the design of the implant used ( cemented or uncemented ) affects the outcome is not known and may be therapeutically important . Questions / purpose sIn this r and omized controlled trial , we sought to compare cemented with cementless fixation in bipolar hemiarthroplasties at 5 years in terms of ( 1 ) Harris hip scores ; ( 2 ) femoral fractures ; ( 3 ) overall health outcomes using the Barthel Index and EQ-5D scores ; and ( 4 ) complications , reoperations , and mortality since our earlier report on this cohort at 1-year followup . Methods We present followup at a median of 5 years after surgery ( range , 56–65 months ) from a r and omized trial comparing a cemented hemiarthroplasty ( 112 hips ) with an uncemented , hydroxyapatite-coated hemiarthroplasty ( 108 hips ) , both with a bipolar head . Results were previously reported at 1-year followup . Harris hip scores , Barthel Index , and EQ-5D scores were assessed by one research nurse and one orthopaedic surgeon . Complications and reoperations were determined by chart review and radiographs examined by three orthopaedic surgeons . Sixty patients ( 56 % ) had died in the cemented group and 63 ( 60 % ) in the uncemented group . Respectively , three and two patients ( 2.7 % and 1.9 % ) were completely lost to followup . Results Harris hip scores at 5 years were higher in the uncemented group than in the cemented group ( 86.2 versus 76.3 ; mean difference 9.9 ; 95 % confidence interval [ CI ] , 1.9–17.9 ) . The prevalence of postoperative periprosthetic femoral fractures was 7.4 % in the uncemented group and 0.9 % in the cemented group ( hazard ratio [ HR ] , 9.3 ; 95 % CI , 1.16–74.5 ) . Barthel Index and EQ-5D scores were not different between the groups . Between 1 and 5 years , we found no additional infections or dislocations . The mortality rate was not different between the groups ( HR , 1.2 ; 95 % CI , 0.82–1.7 ) . Conclusions Both arthroplasties may be used with good medium-term results after displaced femoral neck fractures . The uncemented hemiarthroplasty may result in higher hip scores but appears to carry an unacceptably high risk of later femoral fractures . Level of Evidence Level I , therapeutic study . See the Guidelines for Authors for a complete description of levels of evidence Objective To compare the functional results after displaced fractures of the femoral neck treated with internal fixation or hemiarthroplasty . Design R and omised trial with blinding of assessment s of functional results . Setting University hospital . Participants 222 patients ; 165 ( 74 % ) women , mean age 83 years . Inclusion criteria were age above 60 , ability to walk before the fracture , and no major hip pathology , regardless of cognitive function . Interventions Closed reduction and two parallel screws ( 112 patients ) and bipolar cemented hemiarthroplasty ( 110 patients ) . Follow-up at 4 , 12 , and 24 months . Main outcome measures Hip function ( Harris hip score ) , health related quality of life ( Eq-5d ) , activities of daily living ( Barthel index ) . In all cases high scores indicate better function . Results Mean Harris hip score in the hemiarthroplasty group was 8.2 points higher ( 95 % confidence interval 2.8 to 13.5 points , P=0.003 ) at four months and 6.7 points ( 1.5 to 11.9 points , P=0.01 ) higher at 12 months . Mean Eq-5d index score at 24 months was 0.13 higher in the hemiarthroplasty group ( 0.01 to 0.25 , P=0.03 ) . The Eq-5d visual analogue scale was 8.7 points higher in the hemiarthroplasty group after 4 months ( 1.9 to 15.6 , P=0.01 ) . After 12 and 24 months the percentage scoring 95 or 100 on the Barthel index was higher in the hemiarthroplasty group ( relative risk 0.67 , 0.47 to 0.95 , P=0.02 . and 0.63 , 0.42 to 0.94 , P=0.02 , respectively ) . Complications occurred in 56 ( 50 % ) patients in the internal fixation group and 16 ( 15 % ) in the hemiarthroplasty group ( 3.44 , 2.11 to 5.60 , P<0.001 ) . In each group 39 patients ( 35 % ) died within 24 months ( 0.98 , 0.69 to 1.40 , P=0.92 ) Conclusions Hemiarthroplasty is associated with better functional outcome than internal fixation in treatment of displaced fractures of the femoral neck in elderly patients . Trial registration NCT00464230 BACKGROUND Controversy exists regarding the use of cement for hemiarthroplasty to treat a displaced subcapital femoral neck fracture in elderly patients . The primary hypothesis of this study was that use of cement would provide better visual analog pain scores following this procedure in an elderly patient population . METHODS Elderly patients ( at least seventy years of age ) without severe cardiopulmonary compromise who presented to one institution with a displaced subcapital femoral neck fracture were offered inclusion in the study . One hundred and sixty patients ( mean age , eighty-five years ) with an acute displaced femoral neck fracture were r and omly allocated to hemiarthroplasty with either a cemented Exeter or an uncemented Zweymüller Alloclassic component . Clinical and radiographic follow-up was performed for two years and the outcomes were recorded by a blinded assessor . The main clinical outcome measures were pain , mortality , mobility , complications , reoperations , and quality of life measured with use of vali date d instruments . RESULTS The mean visual analog pain score at rest did not differ significantly between the groups . The total number of complications was greater in the uncemented group ( sixty-three compared with twenty-eight in the cemented group ) . Subsidence was significantly more common in the uncemented group ( eighteen compared with one in the cemented group ) . Intraoperative or postoperative fracture was also significantly more common in the uncemented group ( eighteen compared with one in the cemented group ) . The mortality rate did not differ significantly between the groups at any time point ( thirty-five deaths in the uncemented group compared with thirty-two in the cemented group at two years ) . The Oxford hip score was significantly poorer in the uncemented group at six weeks ( 38.8 compared with 35.7 in the cemented group ) , and it was also poorer or similar at later follow-up time points although the differences were not significant . There was also a trend toward poorer mobility and greater dependence on walking aids in the cemented group . The postoperative Short Musculoskeletal Function Assessment and Mini-Mental State Examination scores did not differ significantly between the groups . CONCLUSIONS In elderly patients ( seventy years or older ) without severe cardiopulmonary compromise who were treated with hemiarthroplasty for a displaced femoral neck fracture , use of a cemented Exeter implant and use of an uncemented Alloclassic implant provided a comparable outcome with regard to pain . However , implant-related complication rates were significantly lower in the group treated with a cemented implant . Trends toward better function and better mobility in the cemented group were observed . These trends reached significance in particular functional scores at some postoperative time points . LEVEL OF EVIDENCE Therapeutic Level II . See Instructions for Authors for a complete description of levels of evidence In a prospect i ve , controlled study , we measured the effect on cardiac output of the introduction of methylmethacrylate during hemiarthroplasty for displaced fractures of the femoral neck . We treated 20 elderly patients who were similar in age , height , weight and preoperative left ventricular function with either cemented or uncemented hemiarthroplasty .  Using a transoesophageal Doppler probe , we measured cardiac output before incision and at six stages of the procedure : during the surgical approach , reaming and lavage of the femoral canal , the introduction of cement , the insertion of the prosthesis , and in reduction and closure . We found that before the cement was introduced , there was no difference in stroke volume or cardiac output ( p > 0.25 ) . Cementation produced a transient but significant reduction in cardiac output of 33 % ( p < 0.01 ) and a reduction in stroke volume of 44 % ( p < 0.02 ) . The introduction of cement did not affect the heart 
    Output:
    
Prosthesis-related complications like fractures and subsidence and general complications like lung complications were more in uncemented group .
Mortality at 1 year was more in cemented group .
Secondary outcomes Mean surgical time was lesser in uncemented cases .
There was no difference in blood loss and re-operation rates .
Conclusion Cementing techniques are here to stay , until a better , durable and more stable uncemented stem evolves , that could lessen the complications related to uncemented surgeries and match the cemented implants in pain relief and ambulation