Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
Abstract Background This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures. Methods Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthrop...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-017-0629-5 |
| _version_ | 1811279758217969664 |
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| author | Feng-Jen Tseng Wei-Tso Chia Ru-Yu Pan Leou-Chyr Lin Hsian-Chung Shen Chih-Hung Wang Jia-Fwu Shyu Ching-Feng Weng |
| author_facet | Feng-Jen Tseng Wei-Tso Chia Ru-Yu Pan Leou-Chyr Lin Hsian-Chung Shen Chih-Hung Wang Jia-Fwu Shyu Ching-Feng Weng |
| author_sort | Feng-Jen Tseng |
| collection | DOAJ |
| description | Abstract Background This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures. Methods Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA. Results Pooled direct and indirect results indicated no significant difference in mortality between THA and HA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17, 95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74; P = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA and HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA than osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition in inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA, HA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and THA had significantly lower revision rates compared with osteosynthesis. Conclusions There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA and THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide support for the use of hip arthroplasty to treat displaced fractures of the femoral neck. |
| first_indexed | 2024-04-13T01:01:30Z |
| format | Article |
| id | doaj.art-e8bf5ee17d444d32989edfe4cf90ec9b |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-13T01:01:30Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-e8bf5ee17d444d32989edfe4cf90ec9b2022-12-22T03:09:28ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2017-09-0112111510.1186/s13018-017-0629-5Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysisFeng-Jen Tseng0Wei-Tso Chia1Ru-Yu Pan2Leou-Chyr Lin3Hsian-Chung Shen4Chih-Hung Wang5Jia-Fwu Shyu6Ching-Feng Weng7Department of Life Science and the Institute of Biotechnology, National Dong Hwa UniversityDepartment of Health, Hsin Chu General HospitalDepartment of Orthopaedics, Tri-Service General Hospital, National Defense Medical CenterDepartment of Orthopaedics, Tri-Service General Hospital, National Defense Medical CenterDepartment of Orthopaedics, Tri-Service General Hospital, National Defense Medical CenterGraduate Institute of Medical Science, National Defense Medical CenterDepartment of Biology and Anatomy, National Defense Medical CenterDepartment of Life Science and the Institute of Biotechnology, National Dong Hwa UniversityAbstract Background This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures. Methods Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA. Results Pooled direct and indirect results indicated no significant difference in mortality between THA and HA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17, 95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74; P = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA and HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA than osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition in inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA, HA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and THA had significantly lower revision rates compared with osteosynthesis. Conclusions There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA and THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide support for the use of hip arthroplasty to treat displaced fractures of the femoral neck.http://link.springer.com/article/10.1186/s13018-017-0629-5Meta-analysisDisplaced femoral neck fracturesArthroplastyOsteosynthesisElderlyOpen reduction internal fixation |
| spellingShingle | Feng-Jen Tseng Wei-Tso Chia Ru-Yu Pan Leou-Chyr Lin Hsian-Chung Shen Chih-Hung Wang Jia-Fwu Shyu Ching-Feng Weng Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis Journal of Orthopaedic Surgery and Research Meta-analysis Displaced femoral neck fractures Arthroplasty Osteosynthesis Elderly Open reduction internal fixation |
| title | Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis |
| title_full | Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis |
| title_fullStr | Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis |
| title_full_unstemmed | Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis |
| title_short | Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis |
| title_sort | comparison of arthroplasty vs osteosynthesis for displaced femoral neck fractures a meta analysis |
| topic | Meta-analysis Displaced femoral neck fractures Arthroplasty Osteosynthesis Elderly Open reduction internal fixation |
| url | http://link.springer.com/article/10.1186/s13018-017-0629-5 |
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