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
Abstract Background We performed an updated systematic review and meta-analysis which enrolled 25 prospective randomized controlled trials (RCTs) to compare the outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fractures (FNFs). Methods We searched...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-020-02122-6 |
| _version_ | 1817992407881351168 |
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| author | Xiumei Tang Duan Wang Ying Liu Jiali Chen Zongke Zhou Peifang Li Ning Ning |
| author_facet | Xiumei Tang Duan Wang Ying Liu Jiali Chen Zongke Zhou Peifang Li Ning Ning |
| author_sort | Xiumei Tang |
| collection | DOAJ |
| description | Abstract Background We performed an updated systematic review and meta-analysis which enrolled 25 prospective randomized controlled trials (RCTs) to compare the outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fractures (FNFs). Methods We searched English databases which included PubMed, Embase (vis OvidSP), The Cochrane Library, and Web of Science, and Chinese databases Chinese National Knowledge Infrastructure (CNKI), VIP, Wang Fang, and China Biology Medicine Disc (CBM) in July 2020. The quality of each study was assessed according to the Cochrane Collaboration’s Risk of Bias. Risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were pooled with random-effects models. Data regarding baseline characteristics, hospital and surgery outcomes, clinical outcomes, patients’ quality of life, common complications, prothesis-related complications, mortality, and costs were reported. Results A total of 25 RCTs involving 3223 patients (1568 THA and 1655 HA) were included. THA had longer hospital length (WMD = 0.721, P < 0.0001) and surgery time (WMD = 20.044, P < 0.0001), and more blood loss compared with HA (WMD = 69.109, P < 0.0001). THA showed better ratings in the Harris Hip Score during follow-up periods between 1 and 5 years while no differences within 6 months and after 9 years. THA was associated with higher quality-of-life EuroQol-5 Dimension (EQ-5D) scores after 2 years of surgery but no difference within 1 year. There was no difference in common complications. THA had significant higher rate of dislocation (WMD = 1.897, P = 0.002) and lower acetabular erosion (WMD = 0.030, P = 0.001). For mortality, there was no difference during all the follow-up periods except for slightly higher 2-year mortality after surgery. Conclusion This meta-analysis demonstrates that THA has better medium-term functional results and quality of life and lower acetabular erosion rate, while HA shows better in reducing hospital stay, surgery time, and blood loss and also has lower dislocation rate. |
| first_indexed | 2024-04-14T01:25:53Z |
| format | Article |
| id | doaj.art-f1aed63b690e4f7594b9835a7a398233 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T01:25:53Z |
| publishDate | 2020-12-01 |
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| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-f1aed63b690e4f7594b9835a7a3982332022-12-22T02:20:27ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-12-0115111510.1186/s13018-020-02122-6The comparison between total hip arthroplasty and hemiarthroplasty in patients with femoral neck fractures: a systematic review and meta-analysis based on 25 randomized controlled trialsXiumei Tang0Duan Wang1Ying Liu2Jiali Chen3Zongke Zhou4Peifang Li5Ning Ning6West China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan UniversityWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan UniversityWest China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan UniversityAbstract Background We performed an updated systematic review and meta-analysis which enrolled 25 prospective randomized controlled trials (RCTs) to compare the outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fractures (FNFs). Methods We searched English databases which included PubMed, Embase (vis OvidSP), The Cochrane Library, and Web of Science, and Chinese databases Chinese National Knowledge Infrastructure (CNKI), VIP, Wang Fang, and China Biology Medicine Disc (CBM) in July 2020. The quality of each study was assessed according to the Cochrane Collaboration’s Risk of Bias. Risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were pooled with random-effects models. Data regarding baseline characteristics, hospital and surgery outcomes, clinical outcomes, patients’ quality of life, common complications, prothesis-related complications, mortality, and costs were reported. Results A total of 25 RCTs involving 3223 patients (1568 THA and 1655 HA) were included. THA had longer hospital length (WMD = 0.721, P < 0.0001) and surgery time (WMD = 20.044, P < 0.0001), and more blood loss compared with HA (WMD = 69.109, P < 0.0001). THA showed better ratings in the Harris Hip Score during follow-up periods between 1 and 5 years while no differences within 6 months and after 9 years. THA was associated with higher quality-of-life EuroQol-5 Dimension (EQ-5D) scores after 2 years of surgery but no difference within 1 year. There was no difference in common complications. THA had significant higher rate of dislocation (WMD = 1.897, P = 0.002) and lower acetabular erosion (WMD = 0.030, P = 0.001). For mortality, there was no difference during all the follow-up periods except for slightly higher 2-year mortality after surgery. Conclusion This meta-analysis demonstrates that THA has better medium-term functional results and quality of life and lower acetabular erosion rate, while HA shows better in reducing hospital stay, surgery time, and blood loss and also has lower dislocation rate.https://doi.org/10.1186/s13018-020-02122-6Total hip arthroplastyHemiarthroplastyFemoral neck fracturesRandomized controlled trials |
| spellingShingle | Xiumei Tang Duan Wang Ying Liu Jiali Chen Zongke Zhou Peifang Li Ning Ning 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 Journal of Orthopaedic Surgery and Research Total hip arthroplasty Hemiarthroplasty Femoral neck fractures Randomized controlled trials |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Total hip arthroplasty Hemiarthroplasty Femoral neck fractures Randomized controlled trials |
| url | https://doi.org/10.1186/s13018-020-02122-6 |
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