Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (35): 6483-6496.doi: 10.3969/j.issn.1673-8225.2010.35.006

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Total hip replacement versus femoral head replacement in treatment of elderly femoral neck fracture: Meta analysis of efficacy and safety

Chen Guang-dong1, Wang Zhen-bin2, Chen Jian-chang3, Lu Lan-hong4, Li Xiu-qing5, Wang Hui-cai6   

  1. 1 Xinjiang Medical University, Urumchi  830011, Xinjiang Uygur Autonomous Region, China; 2 First Department of Spinal Surgery, Fourth Affiliated Hospital of Xinjiang Medical University, Urumchi  830000, Xinjiang Uygur Autonomous Region, China; 3 Orthopedics Center of Urumchi General Hospital, Lanzhou Military Area Command of Chinese PLA, Urumchi  830000, Xinjiang Uygur Autonomous Region, China; 4 Cangzhou Medical College, Cangzhou  061001, Hebei Province, China; 5 Cangzhou People’s Hospital, Cangzhou  061001, Hebei Province, China; 6 Teaching and Research Section of Evidence-based Medicine, First Hospital of Xinjiang Medical University, Urumchi  830011, Xinjiang Uygur Autonomous Region, China
  • Online:2010-08-27 Published:2010-08-27
  • Contact: Wang Zhen-bin, Master, Associate chief physician, First Department of Spinal Surgery, Fourth Affiliated Hospital of Xinjiang Medical University, Urumchi 830000, Xinjiang Uygur Autonomous Region, China wangzb0202@163.com
  • About author:Chen Guang-dong★, Studying for master’s degree, Xinjiang Medical University, Urumchi 830011, Xinjiang Uygur Autonomous Region, China victordongdong@sina.com

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Abstract:

OBJECTIVE: To compare the clinical outcomes and safety between total hip replacement and femoral head replacement in treatment of elderly patients with femoral neck fracture based on Meat analysis of large samples.
METHODS: A computer-based online search of CBM (2010-04), CNKI (2010-04) and VIP (2010-04) was performed for clinical randomized trials regarding total hip replacement and femoral head replacement in treatment of elderly patients with femoral neck fracture. Meta analysis was used to analyze prosthesis function, operation time, bleeding, complication and hip pain.
RESULTS: A total of 7 clinical control studies were included, involving 624 patients aged > 60 years, including 329 patients undergoing total hip replacement (experimental group) and 295 undergoing femoral head replacement (control group). Meta analysis showed that the efficacy of total hip replacement was better than femoral head replacement [OR=2.88, 95% confidence interval (1.84, 4.49), P < 0.05]. The operation time of experimental group was longer than control group [WMD=43.35, 95% confidence interval (23.96, 62.74), P < 0.05]. The bleeding volume of experimental group was greater than control group [WMD=336.36, 95% confidence interval (196.34, 476.37), P < 0.05]. There were no significant differences in complications between two groups [OR=0.54, 95% confidence interval (0.29, 1.02), P > 0.05]. The hip joint pain of experimental group was less than control group [OR=0.30, 95% confidence interval (0.18, 0.50), P < 0.05].
CONCLUSION: Total hip replacement exhibited better long-term clinical outcomes compared with femoral head replacement in treatment of elderly femoral head fracture, in particular for primary hip disease and for patients with strong activity. However, the operation time and bleeding volume were greater than femoral head replacement. Large sample, randomized, controlled studies are required for further validation.

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