Total Hip Arthroplasty Versus Hemiarthroplasty for Displaced Femoral Neck Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(9):6 J Bone Joint Surg Am . 2020 Sep 16;102(18):1638-1645¿Qué significa esto para mi consulta?
Pooled study results suggest that in patients suffering from displaced femoral neck fractures, total hip arthroplasty can help improve quality of life vs. hemiarthroplasty, has a longer operative time for treatment. This meta-analysis was limited by the small number of studies included for quality of life and functional outcome analyses, as well as the variation in functional outcomes (i.e., Harris hip score, WOMAC function, among others). Furthermore, a high heterogeneity was observed for outcome analyses including operative time and incidence of dislocation. Therefore, future studies are required to confirm the findings of this study.
Resumen del estudio
Sixteen 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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