Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures: a systematic review and meta-analysis of randomized controlled trials

Journal of Orthopaedic Surgery and Research

Dike Ruan¹  Qing He¹  Deli Wang¹  Haifeng Li¹  Wei Li¹  Yaohong Wu¹  Fan Ding²  Zhiwei Jia¹ 

[1] Department of Orthopaedics, Navy General Hospital, Beijing, China;Department of Orthopaedics, Wuhan Pu’Ai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

关键词: Meta-analysis;    Systematic review;    Randomized controlled trials;    Hemiarthroplasty;    Arthroplasty;    Femoral neck fractures;   

Others  :  1138734
DOI  :  10.1186/s13018-015-0165-0

 received in 2014-09-16, accepted in 2015-01-14,  发布年份 2015

【 摘 要 】

Background

Whether bipolar hemiarthroplasty (BH) for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty (UH) remains controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the relative effects between BH and UH.

Methods

A systematic literature search (up to April, 2014) was conducted to include RCTs comparing BH with UH for displaced femoral neck fractures. Two authors independently assessed methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed.

Results

A total of 10 RCTs including 1,190 patients were indentified. Our results demonstrated that BH was associated with similar or better outcomes in hip function, hip pain, and quality of life while with a higher cost compared with UH. Moreover, there were no significant differences between BH and UH with regard to operation time, blood loss, blood transfusion, hospital stay, mortality, reoperation, dislocation, and complications. BH could significantly decrease the incidence of acetabular erosion at 1 year follow-up compared with UH (RR = 0.24, 95% confidence interval (CI) = 0.06 to 0.89, P = 0.03), but no significant difference was observed at 4 months, 2 years, and 4 years follow-ups.

Conclusions

Based on the current evidence, BH is not superior to UH in terms of surgical information and postoperative results. Despite similar or better clinical outcomes compared with UH, BH with a higher cost could not decrease long-term acetabular erosion rate.

【 授权许可】

   
2015 Jia et al.; licensee BioMed Central.

【 图 表 】

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