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Published in: Clinical Orthopaedics and Related Research® 8/2012

01-08-2012 | Survey

Total Hip Arthroplasty Versus Hemiarthroplasty for Displaced Femoral Neck Fractures: Meta-analysis of Randomized Trials

Authors: Ligang Yu, MM, Yan Wang, MD, Jiying Chen, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2012

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Abstract

Background

Most patients with displaced femoral neck fractures are treated by THA and hemiarthroplasty, but it remains uncertain which if either is associated with better function and lower risks of complications.

Questions/purposes

We performed a meta-analysis of randomized controlled trials (RCTs) to determine whether THA was associated with lower rates of reoperations, mortality, complications, and better function compared with hemiarthroplasty.

Methods

We searched the PubMed, Embase, Chinese Biomedicine Literature, and Cochrane Register of Controlled Trials databases and identified 12 RCTs (including a total of 1320 patients) for meta-analysis. Risk ratios (RRs) and weighted mean differences (WMDs) from each trial were pooled using random-effects or fixed-effects models depending on the heterogeneity of the included studies.

Results

THA was associated with a lower risk of subsequent reoperations compared with hemiarthroplasty (RR = 0.53; 95% CI, 0.34–0.84). There was no difference in mortality between patients undergoing THA and hemiarthroplasty (RR = 0.81; 95% CI, 0.60–1.09). For complications, there was a higher risk of dislocation in patients undergoing THA (RR = 1.99; 95% CI, 1.26–3.15), but there were no differences in local infections (RR = 1.60; 95% CI, 0.74–3.46) and general complications (RR = 1.15; 95% CI, 0.91–1.45). Patients with THA had higher Harris hip scores at 1 year (WMD = 3.81; 95% CI, 0.87–6.74) and at 3 or 4 years (WMD = 10.07; 95% CI, 6.92–13.21).

Conclusions

Despite more dislocations, THA can benefit patients with displaced femoral neck fractures with a lower reoperation rate and higher functional scores.
Appendix
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Metadata
Title
Total Hip Arthroplasty Versus Hemiarthroplasty for Displaced Femoral Neck Fractures: Meta-analysis of Randomized Trials
Authors
Ligang Yu, MM
Yan Wang, MD
Jiying Chen, MD
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 8/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2293-8

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