Greater Quality of Life But Longer Operative Time With THA vs HA for Displaced Femoral Neck Fracture .
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Total Hip Arthroplasty Versus Hemiarthroplasty for Displaced Femoral Neck Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
J Bone Joint Surg Am . 2020 Sep 16;102(18):1638-1645Sixteen randomized controlled studies containing a total of 3084 patients were included in this meta-analysis including patients with displaced femoral neck fractures undergoing total hip arthroplasty (THA; n=1521) or hemiarthroplasty (HA; n=1563). Pooled outcomes of interest included the following: incidence of revision, functional outcomes (evaluated using the Harris hip score), incidence of mortality, health-related quality of life (QoL; evaluated using the EuroQol-5 Dimensions [EQ-5D] Index), incidence of periprosthetic fracture, incidence of dislocation, and operative time. Subgroup analyses was conducted by level of risk of bias. Revision surgery, incidence of mortality and dislocation were all analyzed at 12-60 months follow-up, where as the rest of the outcomes were assessed at 12-36 months. Pooled results revealed that health-related quality of life, evaluated using EQ-5D Index, was statistically significantly in favour of the THA group vs. HA (p=0.001). However, pooled operative time was statistically significantly shorter in the HA group vs THA (p=0.001). All other pooled outcomes were not statistically significantly different between THA and HA (p>0.05).
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