Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (22): 3991-3995.doi: 10.3969/j.issn.1673-8225.2010.22.001

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Meta analysis of total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in elderly patients

Liao Liang, Zhao Jin-min, Su Wei, Sha Ke, Ding Xiao-fei   

  1. Department of Orthopedic Trauma and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Online:2010-05-28 Published:2010-05-28
  • Contact: Zhao Jin-min, Doctor, Professor, Department of Orthopedic Trauma and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China zhaojinmin@126.com
  • About author:Liao Liang★, Studying for master’s degree, Department of Orthopedic Trauma and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China liangge81@126.com

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Abstract:

BACKGROUND: Total hip arthroplasty (THA) and hemiarthroplasty (HA) are effective therapies for displaced femoral neck fractures in eldery patients, but the choice of two procedures in the clinical treatment remains controversial.
OBJECTIVE: To assess the effects of THA versus HA for optimal treatment of femoral neck fracture in the elderly.
METHODS: A computer-based online search of Cochrane central register of controlled trials (first book in 2009), Medline (1966-01/2009-05), EMbase (1984-01/2009-05) and CBM (1979-01/2009-05), CNKI (1979-01/2009-05). Only RCTs that comparing THA with HA in treatment of femoral neck fracture in the elderly were included in a meta-analysis regarding mortality, reoperations and complications. The analysis was performed with software RevMan5.0.18 from the Cochrane collaboration.
RESULTS AND CONCLUSION: A total of 7 RCTs with a total of 648 participants were included. The meta-analysis showed the mortality and postoperative infection rates between THA and HA groups were not significantly different; the average operating room time and blood loss volumes in the THA group were greater than the HA group (P < 0.001). Revision in long-term follow up in the THA group were lower than the HA group (RR = 0.28, 95%CI = 0.12-0.66, P = 0.003). The dislocation in medium-term follow-up in the THA group were greater than the HA group (RR=3.45, 95%CI =1.29-9.19, P = 0.01). The rate of the pain in long-term follow-up in the THA group were lower than the HA group (RR = 0.12, 95%CI = 0.05-0.30, P < 0.000 01). The mobility in the THA group was better than the HA group (RR = 1.32, 95%CI = 1.04-1.68, P = 0.02). Results suggest that, in short-term follow up there was no difference in mortality, reoperation, dislocation, pain, mobility, wound infection rates between the THA and the HA groups; the dislocation occurred in the THA group more frequently than the HA group in medium-term follow up; while, the revision and pain occurrance in the THA group were less than the HA group, and the mobility of the THA group was more superior than the HA group in long-term follow up.

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