![]() ![]() Surgery in these patients is undertaken to facilitate nursing, and provide timely pain relief, rapid mobilization, and accelerated rehabilitation. ĭisplaced and unstable femoral neck fractures (FNF) are most common, and require early surgical intervention with either a total hip arthroplasty (THA), unipolar hemiarthroplasty (U-HHA), or bipolar hemiarthroplasty (B-HHA). Given their high incidence and associated detrimental effects on patient lives, hip fractures are considered a global health and economic burden, with a cost of 13 billion US dollars per year. In the elderly, hip fractures may lead to significant mortality and morbidity, with impaired mobility and inherent loss of independence. These fractures are expected to increase to more than 6 million by 2050, given demographic changes and the increasing incidence in developing countries. Annually, around 1.5 million hip fractures occur worldwide. Most of these fractures are a consequence of trauma and osteoporosis. I, Bayesian network meta-analysis of RCTs. No significant differences in functional outcomes and complication rates were found between cemented and uncemented implants however, a tendency for lower mortality, revision and dislocation rates in cemented implants was evidenced. However, B-HHA had the lowest dislocation rate when compared with U-HHA and THA. THA led to the highest Harris Hip scores and lowest rate of revision surgery compared to B-HHA and U-HHA. Mortality was positively associated with acetabular erosion ( P = 0.006), female gender ( P = 0.007), revision ( P < 0.0001). Cementless implants required a shorter surgical duration (− 18.05 min P = 0.03). THA scored similarly in terms of mortality (LOR 3.89), but had lower rates of revision surgeries (LOR 2.24), higher rates of dislocations (LOR 2.60), and lower rates of acetabular erosion (LOR − 0.02). The THA group had the longest surgical time (SMD 85.74) and the greatest Harris Hip Score (SMD − 17.31). Resultsĭata from 24 RCTs (2808 procedures) were analysed. For the Bayesian network meta-analysis, the standardized mean difference (SMD) and Log Odd Ratio (LOR) were used. All randomized clinical trials comparing two or more of the index surgical interventions for displaced FNF in the elderly were eligible for inclusion. ![]() The literature search was performed in September 2020. This study was conducted according to the PRISMA extension statement for reporting of systematic reviews, and incorporated network meta-analyses of health care interventions. This network meta-analysis compared the outcomes and complication rates of THA versus B-HHA and versus U-HHA in elderly patients with FNF. However, there is still controversy regarding the optimal implant. Displaced femoral neck fractures (FNF) usually require surgical treatment with either a total hip arthroplasty (THA), unipolar hemiarthroplasty (U-HHA), or bipolar hemiarthroplasty (B-HHA). ![]()
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