Top

Journal of Orthopaedic Surgery and Research

Published in:

Open Access 01-12-2023 | Dynamic Hip Screw | Systematic Review

Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients

Authors: Nikolai Ramadanov, Katarzyna Jóźwiak, Michael Hauptmann, Philip Lazaru, Polina Marinova-Kichikova, Dobromir Dimitrov, Roland Becker

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2023

Abstract

Background

Our aim was to determine the best operative procedure in human participants with a displaced or non-displaced femoral neck fracture comparing cannulated screw (CS) fixation, dynamic hip screw (DHS) fixation, hemiarthroplasty (HA), and total hip arthroplasty (THA) in terms of surgical and functional outcomes, reoperation and postoperative complications.

Methods

We searched PubMed, The Cochrane Library, Clinical trials, CINAHL, and Embase for randomized controlled trials (RCTs) or quasi-RCTs up to 31 July 2022. A frequentist network meta-analysis was performed to assess the comparative effects of the four operative procedures, using fixed-effects and random-effects models. Mean differences (MDs) with 95% confidence intervals (CIs) were estimated for continuous variables and odds ratios (ORs) with 95% CIs were estimated for binary variables.

Results

A total of 33 RCTs with 5703 patients were included in our network meta-analysis. CS fixation was best in terms of operation time (CS: MD = − 57.70, 95% CI − 72.78; − 42.62; DHS: MD = − 53.56, 95% CI − 76.17; − 30.95; HA: MD = − 20.90, 95% CI − 30.65; − 11.15; THA: MD = 1.00 reference) and intraoperative blood loss (CS: MD = − 3.67, 95% CI − 4.44; − 2.90; DHS: MD = − 3.20, 95% CI − 4.97; − 1.43; HA: MD = − 1.20, 95% CI − 1.73; − 0.67; THA: MD = 1.00 reference). In life quality and functional outcome, measured at different time points with EQ-5D and the Harris Hip Score (HHS), THA ranked first and HA second (e.g. EQ-5D 2 years postoperatively: CS: MD = − 0.20, 95% CI − 0.29; − 0.11; HA: MD = − 0.09, 95% CI − 0.17; − 0.02; THA: MD = 1.00 reference; HHS 2 years postoperatively: CS: MD = − 5.50, 95% CI − 9.98; − 1.03; DHS: MD = − 8.93, 95% CI − 15.08; − 2.78; HA: MD = − 3.65, 95% CI − 6.74; − 0.57; THA: MD = 1.00 reference). CS fixation had the highest reoperation risk, followed by DHS fixation, HA, and THA (CS: OR = 9.98, 95% CI 4.60; 21.63; DHS: OR = 5.07, 95% CI 2.15; 11.96; HA: OR = 1.60, 95% CI 0.89; 2.89; THA: OR = 1.00 reference).

Conclusion

In our cohort of patients with displaced and non-displaced femoral neck fractures, HHS, EQ-5D, and reoperation risk showed an advantage of THA and HA compared with CS and DHS fixation. Based on these findings, we recommend that hip arthroplasty should be preferred and internal fixation of femoral neck fractures should only be considered in individual cases. Level of evidence I: a systematic review of randomized controlled trials.

Trial registration: PROSPERO on 10 August 2022 (CRD42022350293).

Available only for authorised users

Stevens JA, Rudd RA. The impact of decreasing U.S. hip fracture rates on future hip fracture estimates. Osteoporos Int. 2013;24(10):2725–58. https://doi.org/10.1007/s00198-013-2375-9.CrossRefPubMedPubMedCentral

Marks R, Allegrante JP, Ronald MacKenzie C, Lane JM. Hip fractures among the elderly: causes, consequences and control. Ageing Res Rev. 2003;2(1):57–93. https://doi.org/10.1016/s1568-1637(02)00045-4.CrossRefPubMed

Garden RS. Stability and union in subcapital fractures of the femur. J Bone Joint Surg Br. 1964;46:630–47.CrossRefPubMed

Nandi S. Revisiting Pauwels’ classification of femoral neck fractures. World J Orthop. 2021;12(11):811–5. https://doi.org/10.5312/wjo.v12.i11.811.CrossRefPubMedPubMedCentral

Florschutz AV, Langford JR, Haidukewych GJ, Koval KJ. Femoral neck fractures: current management. J Orthop Trauma. 2015;29(3):121–9. https://doi.org/10.1097/BOT.0000000000000291.CrossRefPubMed

Xu WN, Xue QY. Long-term efficacy of screw fixation vs hemiarthroplasty for undisplaced femoral neck fracture in patients over 65 years of age: a systematic review and meta-analysis. Orthop Surg. 2021;13(1):3–13. https://doi.org/10.1111/os.12910.CrossRefPubMedPubMedCentral

Bigoni M, Turati M, Leone G, Caminita AD, D’Angelo F, Munegato D, Zatti G. Internal fixation of intracapsular femoral neck fractures in elderly patients: mortality and reoperation rate. Aging Clin Exp Res. 2020;32(6):1173–8. https://doi.org/10.1007/s40520-019-01237-z.CrossRefPubMed

Ma HH, Chou TA, Tsai SW, Chen CF, Wu PK, Chen WM. Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis. J Orthop Surg Res. 2019;14(1):320. https://doi.org/10.1186/s13018-019-1377-5.CrossRefPubMedPubMedCentral

Ramadanov N, Toma I, Herkner H, Klein R, Behringer W, Matthes G. Factors that influence the complications and outcomes of femoral neck fractures treated by cannulated screw fixation. Sci Rep. 2020;10(1):758. https://doi.org/10.1038/s41598-020-57696-2.CrossRefPubMedPubMedCentral

10.

Burgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, Bhandari M, Poolman RW. Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop. 2012;36(8):1549–60. https://doi.org/10.1007/s00264-012-1569-7.CrossRefPubMedPubMedCentral

11.

Lewis DP, Wæver D, Thorninger R, Donnelly WJ. Hemiarthroplasty vs total hip arthroplasty for the management of displaced neck of femur fractures: a systematic review and meta-analysis. J Arthroplasty. 2019;34(8):1837-1843.e2. https://doi.org/10.1016/j.arth.2019.03.070.CrossRefPubMed

12.

Liao L, Zhao J, Su W, Ding X, Chen L, Luo S. A meta-analysis of total hip arthroplasty and hemiarthroplasty outcomes for displaced femoral neck fractures. Arch Orthop Trauma Surg. 2012;132(7):1021–9. https://doi.org/10.1007/s00402-012-1485-8.CrossRefPubMed

13.

Peng W, Bi N, Zheng J, Xi N. Does total hip arthroplasty provide better outcomes than hemiarthroplasty for the femoral neck fracture? A systematic review and meta-analysis. Chin J Traumatol. 2020;23(6):356–62. https://doi.org/10.1016/j.cjtee.2020.09.005.CrossRefPubMedPubMedCentral

14.

Wang F, Zhang H, Zhang Z, Ma C, Feng X. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord. 2015;16:229. https://doi.org/10.1186/s12891-015-0696-x.CrossRefPubMedPubMedCentral

15.

Zhang BF, Wang PF, Huang H, Cong YX, Wang H, Zhuang Y. Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials. Sci Rep. 2017;7(1):13103. https://doi.org/10.1038/s41598-017-13377-1.CrossRefPubMedPubMedCentral

16.

Stoffel K, Zderic I, Gras F, Sommer C, Eberli U, Mueller D, Oswald M, Gueorguiev B. Biomechanical evaluation of the femoral neck system in unstable Pauwels III femoral neck fractures: a comparison with the dynamic hip screw and cannulated screws. J Orthop Trauma. 2017;31(3):131–7. https://doi.org/10.1097/BOT.0000000000000739.CrossRefPubMed

17.

Lim EJ, Shon HC, Cho JW, Oh JK, Kim J, Kim CH. Dynamic hip screw versus cannulated cancellous screw in Pauwels type II or type III femoral neck fracture: a systematic review and meta-analysis. J Pers Med. 2021;11(10):1017. https://doi.org/10.3390/jpm11101017.CrossRefPubMedPubMedCentral

18.

Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, Ioannidis JP, Straus S, Thorlund K, Jansen JP, Mulrow C, Catalá-López F, Gøtzsche PC, Dickersin K, Boutron I, Altman DG, Moher D. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):777–84. https://doi.org/10.7326/M14-2385.CrossRefPubMed

19.

Brooks R, Boye KS, Slaap B. EQ-5D: a plea for accurate nomenclature. J Patient Rep Outcomes. 2020;4(1):52. https://doi.org/10.1186/s41687-020-00222-9.CrossRefPubMedPubMedCentral

20.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–55. https://doi.org/10.2106/00004623-196951040-00012.CrossRefPubMed

21.

Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng HY, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https://doi.org/10.1136/bmj.l4898.CrossRefPubMed

22.

Rücker G, Schwarzer G. Ranking treatments in frequentist network meta-analysis works without resampling methods. BMC Med Res Methodol. 2015;15:58. https://doi.org/10.1186/s12874-015-0060-8.CrossRefPubMedPubMedCentral

23.

Neupane B, Richer D, Bonner AJ, Kibret T, Beyene J. Network meta-analysis using R: a review of currently available automated packages. PLoS ONE. 2014;9(12):e115065. https://doi.org/10.1371/journal.pone.0115065.CrossRefPubMedPubMedCentral

24.

Higgins JPT, Deeks J, Altman D. Special topics in statistics. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration; 2011. chap 16. https://handbook-5-1.cochrane.org/chapter_16/16_1_3_1imputing_standard_deviations.htm.

25.

Avery PP, Baker RP, Walton MJ, Rooker JC, Squires B, Gargan MF, Bannister GC. Total hip replacement and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck: a seven- to ten-year follow-up report of a prospective randomised controlled trial. J Bone Joint Surg Br. 2011;93(8):1045–8. https://doi.org/10.1302/0301-620X.93B8.27132.CrossRefPubMed

26.

Baker RP, Squires B, Gargan MF, Bannister GC. Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial. J Bone Joint Surg Am. 2006;88(12):2583–9. https://doi.org/10.2106/JBJS.E.01373.CrossRefPubMed

27.

Blomfeldt R, Törnkvist H, Eriksson K, Söderqvist A, Ponzer S, Tidermark J. A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007;89(2):160–5. https://doi.org/10.1302/0301-620X.89B2.18576.CrossRefPubMed

28.

Cadossi M, Chiarello E, Savarino L, Tedesco G, Baldini N, Faldini C, Giannini S. A comparison of hemiarthroplasty with a novel polycarbonate-urethane acetabular component for displaced intracapsular fractures of the femoral neck: a randomised controlled trial in elderly patients. Bone Joint J. 2013;95-B(5):609–15. https://doi.org/10.1302/0301-620X.95B5.31083.CrossRefPubMed

29.

Chammout G, Kelly-Pettersson P, Hedbeck CJ, Stark A, Mukka S, Sköldenberg O. HOPE-trial: hemiarthroplasty compared with total hip arthroplasty for displaced femoral neck fractures in octogenarians: a randomized controlled trial. JB JS Open Access. 2019;4(2):e0059. https://doi.org/10.2106/JBJS.OA.18.00059.CrossRefPubMedPubMedCentral

30.

Davison JN, Calder SJ, Anderson GH, Ward G, Jagger C, Harper WM, Gregg PJ. Treatment for displaced intracapsular fracture of the proximal femur. A prospective, randomised trial in patients aged 65 to 79 years. J Bone Joint Surg Br. 2001;83(2):206–12. https://doi.org/10.1302/0301-620x.83b2.11128.CrossRefPubMed

31.

Dolatowski FC, Frihagen F, Bartels S, Opland V, Šaltytė Benth J, Talsnes O, Hoelsbrekken SE, Utvåg SE. Screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in elderly patients: a multicenter randomized controlled trial. J Bone Joint Surg Am. 2019;101(2):136–44. https://doi.org/10.2106/JBJS.18.00316.CrossRefPubMed

32.

Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial. BMJ. 2007;335(7632):1251–4. https://doi.org/10.1136/bmj.39399.456551.25.CrossRefPubMedPubMedCentral

33.

HEALTH Investigators, Bhandari M, Einhorn TA, Guyatt G, Schemitsch EH, Zura RD, Sprague S, Frihagen F, Guerra-Farfán E, Kleinlugtenbelt YV, Poolman RW, Rangan A, Bzovsky S, Heels-Ansdell D, Thabane L, Walter SD, Devereaux PJ. Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med. 2019;381(23):2199–208. https://doi.org/10.1056/NEJMoa1906190.CrossRef

34.

Hedbeck CJ, Enocson A, Lapidus G, Blomfeldt R, Törnkvist H, Ponzer S, Tidermark J. Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: a concise four-year follow-up of a randomized trial. J Bone Joint Surg Am. 2011;93(5):445–50. https://doi.org/10.2106/JBJS.J.00474.CrossRefPubMed

35.

Iorio R, Iannotti F, Mazza D, Speranza A, Massafra C, Guzzini M, D’Arrigo C, Ferretti A. Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial. SICOT J. 2019;5:38. https://doi.org/10.1051/sicotj/2019035.CrossRefPubMedPubMedCentral

36.

Johansson T, Jacobsson SA, Ivarsson I, Knutsson A, Wahlström O. Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures: a prospective randomized study of 100 hips. Acta Orthop Scand. 2000;71(6):597–602. https://doi.org/10.1080/000164700317362235.CrossRefPubMed

37.

Jónsson B, Sernbo I, Carlsson A, Fredin H, Johnell O. Social function after cervical hip fracture. A comparison of hook-pins and total hip replacement in 47 patients. Acta Orthop Scand. 1996;67(5):431–4. https://doi.org/10.3109/17453679608996662.CrossRefPubMed

38.

Lu Q, Tang G, Zhao X, Guo S, Cai B, Li Q. Hemiarthroplasty versus internal fixation in super-aged patients with undisplaced femoral neck fractures: a 5-year follow-up of randomized controlled trial. Arch Orthop Trauma Surg. 2017;137(1):27–35. https://doi.org/10.1007/s00402-016-2591-9.CrossRefPubMed

39.

Macaulay W, Nellans KW, Iorio R, Garvin KL, Healy WL, Rosenwasser MP, DFACTO Consortium. Total hip arthroplasty is less painful at 12 months compared with hemiarthroplasty in treatment of displaced femoral neck fracture. HSS J. 2008;4(1):48–54. https://doi.org/10.1007/s11420-007-9061-4.CrossRefPubMed

40.

Macaulay W, Nellans KW, Garvin KL, Iorio R, Healy WL, Rosenwasser MP, other members of the DFACTO Consortium. Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures: winner of the Dorr Award. J Arthroplast. 2008;23(6 Suppl 1):2–8. https://doi.org/10.1016/j.arth.2008.05.013.CrossRef

41.

Mjørud J, Skaro O, Solhaug JH, Thorngren KG. A randomised study in all cervical hip fractures osteosynthesis with Hansson hook-pins versus AO-screws in 199 consecutive patients followed for two years. Injury. 2006;37(8):768–77. https://doi.org/10.1016/j.injury.2006.01.001.CrossRefPubMed

42.

Mouzopoulos G, Stamatakos M, Arabatzi H, Vasiliadis G, Batanis G, Tsembeli A, Tzurbakis M, Safioleas M. The four-year functional result after a displaced subcapital hip fracture treated with three different surgical options. Int Orthop. 2008;32(3):367–73. https://doi.org/10.1007/s00264-007-0321-1.CrossRefPubMed

43.

Narayan KK, George T. Functional outcome of fracture neck of femur treated with total hip replacement versus bipolar arthroplasty in a South Asian population. Arch Orthop Trauma Surg. 2006;126(8):545–8. https://doi.org/10.1007/s00402-006-0182-x.CrossRefPubMed

44.

Parker MJ, Khan RJ, Crawford J, Pryor GA. Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures in the elderly. A randomised trial of 455 patients. J Bone Joint Surg Br. 2002;84(8):1150–5. https://doi.org/10.1302/0301-620x.84b8.13522.CrossRefPubMed

45.

Parker MJ, Cawley S. Treatment of the displaced intracapsular fracture for the “fitter” elderly patients: a randomised trial of total hip arthroplasty versus hemiarthroplasty for 105 patients. Injury. 2019;50(11):2009–13. https://doi.org/10.1016/j.injury.2019.09.018.CrossRefPubMed

46.

Ravikumar KJ, Marsh G. Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur–13 year results of a prospective randomised study. Injury. 2000;31(10):793–7. https://doi.org/10.1016/s0020-1383(00)00125-x.CrossRefPubMed

47.

Rödén M, Schön M, Fredin H. Treatment of displaced femoral neck fractures: a randomized minimum 5-year follow-up study of screws and bipolar hemiprostheses in 100 patients. Acta Orthop Scand. 2003;74(1):42–4. https://doi.org/10.1080/00016470310013635.CrossRefPubMed

48.

Schleicher I, Kordelle J, Jürgensen I, Haas H, Melzer C. Die Schenkelhalsfraktur beim alten Menschen-Bipolare Hemiendoprothese vs. Totalendoprothese [Femoral neck fractures in the elderly—bipolar hemiarthroplasty in total hip replacement]. Unfallchirurg. 2003;106(6):467–71. https://doi.org/10.1007/s00113-003-0597-6. (German).CrossRefPubMed

49.

Sharma V, Awasthi B, Kumar K, Kohli N, Katoch P. Outcome Analysis of hemiarthroplasty vs. total hip replacement in displaced femoral neck fractures in the elderly. J Clin Diagn Res. 2016;10(5):RC11–3. https://doi.org/10.7860/JCDR/2016/18638.7877.CrossRefPubMedPubMedCentral

50.

Sonaje JC, Meena PK, Bansiwal RC, Bobade SS. Comparison of functional outcome of bipolar hip arthroplasty and total hip replacement in displaced femoral neck fractures in elderly in a developing country: a 2-year prospective study. Eur J Orthop Surg Traumatol. 2018;28(3):493–8. https://doi.org/10.1007/s00590-017-2057-y.CrossRefPubMed

51.

Støen RØ, Lofthus CM, Nordsletten L, Madsen JE, Frihagen F. Randomized trial of hemiarthroplasty versus internal fixation for femoral neck fractures: no differences at 6 years. Clin Orthop Relat Res. 2014;472(1):360–7. https://doi.org/10.1007/s11999-013-3245-7.CrossRefPubMed

52.

Tidermark J, Ponzer S, Svensson O, Söderqvist A, Törnkvist H. Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial. J Bone Joint Surg Br. 2003;85(3):380–8. https://doi.org/10.1302/0301-620x.85b3.13609.CrossRefPubMed

53.

Tol MC, van den Bekerom MP, Sierevelt IN, Hilverdink EF, Raaymakers EL, Goslings JC. Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial. Bone Joint J. 2017;99-B(2):250–4. https://doi.org/10.1302/0301-620X.99B2.BJJ-2016-0479.R1.CrossRefPubMed

54.

Ukaj S, Zhuri O, Ukaj F, Podvorica V, Grezda K, Caton J, Prudhon JL, Krasniqi S. Dual mobility acetabular cup versus hemiarthroplasty in treatment of displaced femoral neck fractures in elderly patients: comparative study and results at minimum 3-year follow-up. Geriatr Orthop Surg Rehabil. 2019;10:2151459319848610. https://doi.org/10.1177/2151459319848610.CrossRefPubMedPubMedCentral

55.

van den Bekerom MP, Hilverdink EF, Sierevelt IN, Reuling EM, Schnater JM, Bonke H, Goslings JC, van Dijk CN, Raaymakers EL. A comparison of hemiarthroplasty with total hip replacement for displaced intracapsular fracture of the femoral neck: a randomised controlled multicentre trial in patients aged 70 years and over. J Bone Joint Surg Br. 2010;92(10):1422–8. https://doi.org/10.1302/0301-620X.92B10.24899.CrossRefPubMed

56.

van Vugt AB, Oosterwijk WM, Goris RJ. Osteosynthesis versus endoprosthesis in the treatment of unstable intracapsular hip fractures in the elderly. A randomised clinical trial. Arch Orthop Trauma Surg. 1993;113(1):39–45. https://doi.org/10.1007/BF00440593.CrossRefPubMed

57.

Watson A, Zhang Y, Beattie S, Page RS. Prospective randomized controlled trial comparing dynamic hip screw and screw fixation for undisplaced subcapital hip fractures. ANZ J Surg. 2013;83(9):679–83. https://doi.org/10.1111/j.1445-2197.2012.06256.x.CrossRefPubMed

58.

Okike K, Udogwu UN, Isaac M, Sprague S, Swiontkowski MF, Bhandari M, Slobogean GP, FAITH Investigators. Not all Garden-I and II femoral neck fractures in the elderly should be fixed: effect of posterior tilt on rates of subsequent arthroplasty. J Bone Joint Surg Am. 2019;101(20):1852–9. https://doi.org/10.2106/JBJS.18.01256.CrossRefPubMed

59.

Waaler Bjørnelv GM, Frihagen F, Madsen JE, Nordsletten L, Aas E. Hemiarthroplasty compared to internal fixation with percutaneous cannulated screws as treatment of displaced femoral neck fractures in the elderly: cost-utility analysis performed alongside a randomized, controlled trial. Osteoporos Int. 2012;23(6):1711–9. https://doi.org/10.1007/s00198-011-1772-1.CrossRefPubMed

60.

Sikorski JM, Barrington R. Internal fixation versus hemiarthroplasty for the displaced subcapital fracture of the femur. A prospective randomised study. J Bone Joint Surg Br. 1981;63-B(3):357–61. https://doi.org/10.1302/0301-620X.63B3.7263746.CrossRefPubMed

61.

Neander G, Adolphson P, von Sivers K, Dahlborn M, Dalén N. Bone and muscle mass after femoral neck fracture. A controlled quantitative computed tomography study of osteosynthesis versus primary total hip arthroplasty. Arch Orthop Trauma Surg. 1997;116(8):470–4. https://doi.org/10.1007/BF00387579.CrossRefPubMed

62.

Söreide O, Mölster A, Raugstad TS. Internal fixation versus primary prosthetic replacement in acute femoral neck fractures: a prospective, randomized clinical study. Br J Surg. 1979;66(1):56–60. https://doi.org/10.1002/bjs.1800660118(tooold).CrossRefPubMed

63.

Griffin XL, Parsons N, Achten J, Costa ML. The Targon femoral neck hip screw versus cannulated screws for internal fixation of intracapsular fractures of the hip: a randomised controlled trial. Bone Joint J. 2014;96-B(5):652–7. https://doi.org/10.1302/0301-620X.96B5.33391.CrossRefPubMed

64.

Surace P, Sultan AA, George J, Samuel LT, Khlopas A, Molloy RM, Stearns KL, Mont MA. The association between operative time and short-term complications in total hip arthroplasty: an analysis of 89,802 surgeries. J Arthroplast. 2019;34(3):426–32. https://doi.org/10.1016/j.arth.2018.11.015.CrossRef

65.

Tang X, Wang D, Liu Y, Chen J, Zhou Z, Li P, Ning N. The comparison between total hip arthroplasty and hemiarthroplasty in patients with femoral neck fractures: a systematic review and meta-analysis based on 25 randomized controlled trials. J Orthop Surg Res. 2020;15(1):596. https://doi.org/10.1186/s13018-020-02122-6.CrossRefPubMedPubMedCentral

66.

Li X, Luo J. Hemiarthroplasty compared to total hip arthroplasty for the treatment of femoral neck fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2021;16(1):172. https://doi.org/10.1186/s13018-020-02186-4.CrossRefPubMedPubMedCentral

67.

Ma HH, Chou TA, Pai FY, Tsai SW, Chen CF, Wu PK, Chen WM. Outcomes of dual-mobility total hip arthroplasty versus bipolar hemiarthroplasty for patients with femoral neck fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2021;16(1):152. https://doi.org/10.1186/s13018-021-02316-6.CrossRefPubMedPubMedCentral

68.

Ross D, Erkocak O, Rasouli MR, Parvizi J. Operative time directly correlates with blood loss and need for blood transfusion in total joint arthroplasty. Arch Bone Joint Surg. 2019;7(3):229–34.PubMedPubMedCentral

69.

Quaranta M, Miranda L, Oliva F, Migliorini F, Pezzuti G, Maffulli N. Haemoglobin and transfusions in elderly patients with hip fractures: the effect of a dedicated orthogeriatrician. J Orthop Surg Res. 2021;16(1):387. https://doi.org/10.1186/s13018-021-02524-0.CrossRefPubMedPubMedCentral

70.

Chen YP, Kuo YJ, Hung SW, Wen TW, Chien PC, Chiang MH, Maffulli N, Lin CY. Loss of skeletal muscle mass can be predicted by sarcopenia and reflects poor functional recovery at one year after surgery for geriatric hip fractures. Injury. 2021;52(11):3446–52. https://doi.org/10.1016/j.injury.2021.08.007.CrossRefPubMed

71.

Singh JA, Schleck C, Harmsen S, Lewallen D. Clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total hip arthroplasty. BMC Musculoskelet Disord. 2016;17:256. https://doi.org/10.1186/s12891-016-1106-8.CrossRefPubMedPubMedCentral

72.

Kemp JL, Collins NJ, Roos EM, Crossley KM. Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery. Am J Sports Med. 2013;41(9):2065–73. https://doi.org/10.1177/0363546513494173.CrossRefPubMed

73.

van der Wees PJ, Wammes JJ, Akkermans RP, Koetsenruijter J, Westert GP, van Kampen A, Hannink G, de Waal-Malefijt M, Schreurs BW. Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital setting: results of twenty years clinical registry. BMC Musculoskelet Disord. 2017;18(1):97. https://doi.org/10.1186/s12891-017-1455-y.CrossRefPubMedPubMedCentral

74.

Nwachukwu BU, Chang B, Rotter BZ, Kelly BT, Ranawat AS, Nawabi DH. Minimal clinically important difference and substantial clinical benefit after revision hip arthroscopy. Arthroscopy. 2018;34(6):1862–8. https://doi.org/10.1016/j.arthro.2018.01.050.CrossRefPubMed

75.

Maffulli N, Aicale R. Proximal femoral fractures in the elderly: a few things to know, and some to forget. Medicina (Kaunas). 2022;58(10):1314. https://doi.org/10.3390/medicina58101314.CrossRefPubMed

76.

Zhang LL, Zhang Y, Ma X, Liu Y. Multiple cannulated screws vs. dynamic hip screws for femoral neck fractures: a meta-analysis. Orthopade. 2017;46(11):954–62. https://doi.org/10.1007/s00132-017-3473-8.CrossRefPubMed

Title: Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients
Authors: Nikolai Ramadanov
Katarzyna Jóźwiak
Michael Hauptmann
Philip Lazaru
Polina Marinova-Kichikova
Dobromir Dimitrov
Roland Becker
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Dynamic Hip Screw
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2023
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-023-04114-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

How high is the quality of the videos about children's elbow fractures on Youtube?

Association between muscle strength and mass and bone mineral density in the US general population: data from NHANES 1999–2002

Clock gene Per1 regulates rat temporomandibular osteoarthritis through NF-κB pathway: an in vitro and in vivo study

Clinical outcomes and prediction nomogram model for postoperative hemoglobin < 80 g/L in patients following primary lumbar interbody fusion surgery

Letter to the Editor regarding “Clinical benefit of high tibial osteotomy combined with the intervention of platelet-rich plasma for severe knee osteoarthritis”

Stem cell therapy combined with core decompression versus core decompression alone in the treatment of avascular necrosis of the femoral head: a systematic review and meta-analysis