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Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis

BACKGROUND: This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures. METHODS: Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthroplasty (...

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Autores principales: Tseng, Feng-Jen, Chia, Wei-Tso, Pan, Ru-Yu, Lin, Leou-Chyr, Shen, Hsian-Chung, Wang, Chih-Hung, Shyu, Jia-Fwu, Weng, Ching-Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602948/
https://www.ncbi.nlm.nih.gov/pubmed/28915928
http://dx.doi.org/10.1186/s13018-017-0629-5
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author Tseng, Feng-Jen
Chia, Wei-Tso
Pan, Ru-Yu
Lin, Leou-Chyr
Shen, Hsian-Chung
Wang, Chih-Hung
Shyu, Jia-Fwu
Weng, Ching-Feng
author_facet Tseng, Feng-Jen
Chia, Wei-Tso
Pan, Ru-Yu
Lin, Leou-Chyr
Shen, Hsian-Chung
Wang, Chih-Hung
Shyu, Jia-Fwu
Weng, Ching-Feng
author_sort Tseng, Feng-Jen
collection PubMed
description BACKGROUND: This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures. METHODS: Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA. RESULTS: Pooled direct and indirect results indicated no significant difference in mortality between THA and HA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17, 95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74; P = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA and HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA than osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition in inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA, HA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and THA had significantly lower revision rates compared with osteosynthesis. CONCLUSIONS: There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA and THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide support for the use of hip arthroplasty to treat displaced fractures of the femoral neck.
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spelling pubmed-56029482017-09-20 Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis Tseng, Feng-Jen Chia, Wei-Tso Pan, Ru-Yu Lin, Leou-Chyr Shen, Hsian-Chung Wang, Chih-Hung Shyu, Jia-Fwu Weng, Ching-Feng J Orthop Surg Res Research Article BACKGROUND: This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures. METHODS: Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA. RESULTS: Pooled direct and indirect results indicated no significant difference in mortality between THA and HA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17, 95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74; P = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA and HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA than osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition in inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA, HA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and THA had significantly lower revision rates compared with osteosynthesis. CONCLUSIONS: There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA and THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide support for the use of hip arthroplasty to treat displaced fractures of the femoral neck. BioMed Central 2017-09-15 /pmc/articles/PMC5602948/ /pubmed/28915928 http://dx.doi.org/10.1186/s13018-017-0629-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Tseng, Feng-Jen
Chia, Wei-Tso
Pan, Ru-Yu
Lin, Leou-Chyr
Shen, Hsian-Chung
Wang, Chih-Hung
Shyu, Jia-Fwu
Weng, Ching-Feng
Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
title Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
title_full Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
title_fullStr Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
title_full_unstemmed Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
title_short Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
title_sort comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602948/
https://www.ncbi.nlm.nih.gov/pubmed/28915928
http://dx.doi.org/10.1186/s13018-017-0629-5
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