Lang Li1, Xue Zhao2, Xiaodong Yang1, Lei Yang1, Fei Xing3, Xueyang Tang4. 1. Department of Pediatric Surgery, West China Hospital, Sichuan University, #37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 2. Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 3. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 4. Department of Pediatric Surgery, West China Hospital, Sichuan University, #37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. xueyangtwch@163.com.
Abstract
INTRODUCTION: Hemiarthroplasty is commonly used to treat unstable femoral neck fractures in older patients. However, there is no consensus on the use of cement during hemiarthroplasty. Therefore, we performed a systematic review to focus on the outcomes of cemented and uncemented hemiarthroplasty for the treatment of femoral neck fractures in older patients. MATERIALS AND METHODS: Pubmed, Cochrane Central Register of Controlled Trials, and Ovid were searched for studies related comparison of cemented versus uncemented hemiarthroplasty for unstable femoral neck fractures from inception to Jan 20, 2020. The quality of the included randomized controlled trials (RCTs) was assessed using the Cochrane Collaboration tool. The meta-analysis was performed using the RevMan 5.2 software. RESULTS: Eleven RCTs were included in the meta-analysis. Cemented hemiarthroplasty was found to be superior to uncemented arthroplasty with respect to reoperation rate (RR 0.6, 95% CI 0.38-0.96, p = 0.03), complications related to prosthesis (RR 0.39, 95% CI 0.23-0.68, p = 0.0008), residual pain (RR 0.66, 95% CI 0.52-0.83, p = 0.0004), and operation time (MD 8.22, 95% CI 6.30-10.14, p < 0.00001). There were no significant between-group differences with respect to local and general complications, duration of hospital stay, hip function, and mortality. CONCLUSIONS: This meta-analysis showed cemented hemiarthroplasty might be an optimum choice for treating unstable femoral neck fractures in older patients. However, the results of this meta-analysis should be interpreted cautiously owing to some limitations. Further studies are required to provide more robust evidence.
INTRODUCTION: Hemiarthroplasty is commonly used to treat unstable femoral neck fractures in older patients. However, there is no consensus on the use of cement during hemiarthroplasty. Therefore, we performed a systematic review to focus on the outcomes of cemented and uncemented hemiarthroplasty for the treatment of femoral neck fractures in older patients. MATERIALS AND METHODS: Pubmed, Cochrane Central Register of Controlled Trials, and Ovid were searched for studies related comparison of cemented versus uncemented hemiarthroplasty for unstable femoral neck fractures from inception to Jan 20, 2020. The quality of the included randomized controlled trials (RCTs) was assessed using the Cochrane Collaboration tool. The meta-analysis was performed using the RevMan 5.2 software. RESULTS: Eleven RCTs were included in the meta-analysis. Cemented hemiarthroplasty was found to be superior to uncemented arthroplasty with respect to reoperation rate (RR 0.6, 95% CI 0.38-0.96, p = 0.03), complications related to prosthesis (RR 0.39, 95% CI 0.23-0.68, p = 0.0008), residual pain (RR 0.66, 95% CI 0.52-0.83, p = 0.0004), and operation time (MD 8.22, 95% CI 6.30-10.14, p < 0.00001). There were no significant between-group differences with respect to local and general complications, duration of hospital stay, hip function, and mortality. CONCLUSIONS: This meta-analysis showed cemented hemiarthroplasty might be an optimum choice for treating unstable femoral neck fractures in older patients. However, the results of this meta-analysis should be interpreted cautiously owing to some limitations. Further studies are required to provide more robust evidence.
Authors: Mohamed A Imam; Mohamed S A Shehata; Ahmed Elsehili; Mahmoud Morsi; Alexander Martin; Muhammad Shawqi; Florian Grubhofer; Nish Chirodian; Ali Narvani; Lukas Ernstbrunner Journal: Int Orthop Date: 2019-03-27 Impact factor: 3.075
Authors: Mohamed S A Shehata; Ahmed Abdelal; Sami Salahia; Hussien Ahmed; Muhammad Shawqi; Ahmed Elsehili; Mahmoud Morsi; Ahmed M Afifi; Nardeen Kader; Florian Grubhofer; Asser Sallam; Mohamed Imam Journal: SICOT J Date: 2019-09-06
Authors: Sophie Moerman; Nina M C Mathijssen; Dieu D Niesten; Roeland Riedijk; Willard J Rijnberg; Sander Koëter; Keetie Kremers van de Hei; Wim E Tuinebreijer; Tim L Molenaar; Rob G H H Nelissen; Anne J H Vochteloo Journal: BMC Musculoskelet Disord Date: 2017-04-21 Impact factor: 2.362