Cemented vs uncemented femoral fixation in total hip arthroplasty: A systematic review and meta-analysis of periprosthetic fracture risk

Figure 2 Forest plot showing the risk ratios and 95% confidence intervals for periprosthetic femoral fracture incidence comparing cemented vs uncemented femoral fixation in primary total hip arthroplasty. Each study is represented by a square (proportional to study weight) and horizontal line (95% confidence interval). The pooled random-effects estimate is shown as a diamond at the bottom. The vertical dashed line at risk ratio = 1.0 represents no difference between groups; values to the left favor cemented fixation (lower fracture risk), and values to the right favor uncemented fixation. Heterogeneity statistics are displayed: I² = 93.1%, indicating substantial heterogeneity; χ² = 29.05, P < 0.001. Test for overall effect: Z = 1.31, P = 0.19 (not statistically significant). RR: Risk ratio; CI: Confidence intervals.