Have advances in surgical implants and techniques in hemiarthroplasty for intracapsular hip fractures improved patient outcomes compared to THA? A systematic review and meta-analysis of the evidence

研究概要

13 randomized trials with a total of 2811 patients with intracapsular femoral neck fractures were randomized to receive a hemiarthroplasty technique using an advanced surgical implant or technique (n=1425) or a total hip arthroplasty procedure (n=1386). The primary outcome of interest was hip function, reoperation, and mortality. Secondary outcomes of interest included infection, dislocation, and resource outcomes (length of stay, length of procedure). No differences in pooled primary outcomes were observed between the two groups. The pooled results found that hemiarthroplasty resulted in a lower risk of dislocation and a shorter procedure length, but worse Harris Hip Scores vs. total hip arthroplasty. In the subgroup analyses of studies with a mean participant age >80, the risk of morality was significantly lower in the hemiarthroplasty group. Moreover, when assessing studies with senior performing surgeons, the risk of mortality and dislocation was significantly lower with hemiarthroplasty.