Ninety-nine patients with femoral neck fractures were randomized to receive either cemented stem fixation (n=42) or cementless stem fixation (n=57) during bipolar hemiarthroplasty. The primary outcome of interest was operative time. Secondary outcomes included intraoperative blood loss, use of vasopressors, postoperative activities of daily living (ADLs), and radiological outcomes. Outcomes were assessed up to hospital discharge. Overall, the study revealed that cementless fixation resulted in shorter operative times and lower vasopressor use but showed no significant differences in intraoperative blood loss or postoperative complications between the groups. These findings suggest that cementless fixation might be preferable for reducing certain intraoperative risks.