Table 1.

Data summary table.

Reference	Classification	Relevant outcomes
Morshed et al. [19]	Meta-analysis Primary THA Subgroup analysis by age	•Cemented fixation in THA exhibits superior implant survival for all ages when patients are not stratified by age (P = .004). •Neither fixation in THA has superior implant survival for studies in which all patients are of age ≤55 years.
Abdulkarim et al. [20]	Meta-analysis Primary THA Randomized controlled trials only	•Neither fixation in THA has superior implant survival measured by revision rate (P = .14, n = 719), superior patient mortality (P = .77, n = 725), or lower postoperative complication rates (P = .67, n = 391). •Cemented fixation in THA has superior short-term clinical pain outcomes (P = .04, n = 695).
Ni et al. [21]	Systematic review Femoral stems	•Cemented fixation of femoral stems has better short-term clinical and functional outcomes. •For included RCTs, there is no difference in health-related quality of life or heterotopic ossification rates with respect to femoral stem fixation. •Cementless fixation of femoral stems demonstrated increased thigh pain and reduced walking ability without support.
Hailer et al. [22]	Swedish Registry Data Primary THA	•Ten-year implant survival better for cemented THA (94%) than for cementless THA (85%) (P < .0001). •Stem revision due to periprosthetic fracture within 2 years 8× higher for cementless femoral stems than for cemented femoral stems (P < .001), most likely due to intraoperative femoral stems.
Eskelinen et al. [23] and Mäkelä et al. [24]	Swedish Registry Data Primary THA	•Ten-year implant survival better for with proximally and extendedly porous-coated cementless femoral stems (91% and 89%) than with uncoated cementless femoral stems (80%) or cemented femoral stems (87%).
Engesaeter et al. [25]	Norwegian Registry Data Primary THA	•Cemented THA without antibiotic-impregnated cement is 1.8 times more likely to be revised because of infection than cementless THA (P = .04).
Colas et al. [26]	French Health Insurance Information System Primary THA	•There was a significant decrease in the risk of revision in cemented THA with antibiotic-impregnated cement (2.4%, n = 21,467) vs cementless THA (3.3%, n = 74,917; P < .001).
Eskelinen et al. [23]	Finnish Registry Data Primary THA Younger patients (aged ≤55 years)	•Cementless femoral stems that are proximally circumferentially porous-coated have a lower risk of aseptic loosening failure than cemented femoral stems in younger patients (relative risk: 5.5, P < .001). •Cementless femoral stems were better for patients aged <55 years, both for the risk of all revision (P < .002) and for the risk of revisions due to aseptic loosening (P < .001)
Jämsen et al. [27]	Finnish Registry Older patients (aged ≥80 years)	•One-year survival, cementless femoral stems associated with 2.9 times higher rate of revision, especially in female patients.
Mäkelä et al. [24]	Finnish Registry Intermediate patients (aged 55-64 years)	•15-year survival is better in cementless straight femoral stems (91%) vs cemented load-taper stems (77%; P < .001)
Mäkelä et al. [28]	Swedish, Norwegian, Danish, and Finnish Registries Intermediate patients (aged 55-64 years)	•15-year survival is not influenced by fixation method: cemented fixation (84.1%) and cementless fixation (82.8%).
Havelin et al. [29]	Norwegian Registry Patients aged <60 years	•Relative risk of revision for any reason with porous-coated cementless femoral stems (2.5) compared to hydroxyapatite-coated cementless femoral stems (1.0). •Relative risk of revision for any reason with cemented femoral stems (3.3) compared to hydroxyapatite-coated cementless femoral stems (1.0).
Mäkelä et al. [30]	Finnish Registry Evolution of cementless femoral stems	•Survival-favored cemented stems from 1987 to 1996. •No difference in survival from 1997 to 2006.
Strom et al. [31]	Level I study Femoral stem fixation	•Fixation had no influence on radiographic stability. •Cementless femoral stem group had radiolucent lines in 27% of cases (6/23), cemented femoral stem group had no radiolucent lines (0/23).
Lindalen et al. [32]	Level I Study Femoral stem fixation Cemented femoral stems were collared	•Longer operating time in cemented fixation group (85 min) than in cementless fixation group (77 min; P = .05). •Less blood loss in cemented fixation group (674 mL) than in cementless fixation group (740 mL), not significant (P = .3)
Kim [33]	Level I study Bilateral THA comparison	•Cemented fixation group has more radiolucent lines (9/70 = 12.86%) than the cementless fixation group (3/70 = 4.29%). •Cementless fixation group has a higher incidence of osteolysis (9/70 = 12.86%) than the cemented fixation group (6/70 = 8.57%). •Cementless fixation group has a higher incidence of calcar and displaced fractures of the femur (3 each/70 = 4.29%) than the cemented fixation group (0/70).
Emerson et al. [34]	Level III Femoral stem fixation	•Cemented group has a higher incidence of femoral osteolysis (22/102 = 21.6%) than the cementless group (7/78 = 8.97%; P = .016). •Cemented group had no revisions (0/102), whereas the cementless group had 10 revisions (12.8%; 1 for femoral fracture and 9 for aseptic loosening).