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Meta-Analysis
. 2015 Jan 24:10:8.
doi: 10.1186/s13018-015-0165-0.

Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures: a systematic review and meta-analysis of randomized controlled trials

Zhiwei Jia  1 , Fan Ding  2 , Yaohong Wu  3 , Wei Li  4 , Haifeng Li  5 , Deli Wang  6 , Qing He  7 , Dike Ruan  8
Affiliations
Meta-Analysis

Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures: a systematic review and meta-analysis of randomized controlled trials

Zhiwei Jia et al. J Orthop Surg Res. .

Abstract

Background: Whether bipolar hemiarthroplasty (BH) for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty (UH) remains controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the relative effects between BH and UH.

Methods: A systematic literature search (up to April, 2014) was conducted to include RCTs comparing BH with UH for displaced femoral neck fractures. Two authors independently assessed methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed.

Results: A total of 10 RCTs including 1,190 patients were indentified. Our results demonstrated that BH was associated with similar or better outcomes in hip function, hip pain, and quality of life while with a higher cost compared with UH. Moreover, there were no significant differences between BH and UH with regard to operation time, blood loss, blood transfusion, hospital stay, mortality, reoperation, dislocation, and complications. BH could significantly decrease the incidence of acetabular erosion at 1 year follow-up compared with UH (RR = 0.24, 95% confidence interval (CI) = 0.06 to 0.89, P = 0.03), but no significant difference was observed at 4 months, 2 years, and 4 years follow-ups.

Conclusions: Based on the current evidence, BH is not superior to UH in terms of surgical information and postoperative results. Despite similar or better clinical outcomes compared with UH, BH with a higher cost could not decrease long-term acetabular erosion rate.

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Figures

Figure 1
Figure 1
The flow chart of study selection.
Figure 2
Figure 2
Quality assessment of risk of bias in included studies.
Figure 3
Figure 3
Acetabular erosion.
See this image and copyright information in PMC

References

    1. Bhandari M, Devereaux PJ, Tornetta P, 3rd, Swiontkowski MF, Berry DJ, Haidukewych G, et al. Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Joint Surg Am. 2005;87:2122–30. doi: 10.2106/JBJS.E.00535. - DOI - PubMed
    1. Iorio R, Schwartz B, Macaulay W, Teeney SM, Healy WL, York S. Surgical treatment of displaced femoral neck fractures in the elderly: a survey of the American Association of Hip and Knee Surgeons. J Arthroplasty. 2006;21:1124–33. doi: 10.1016/j.arth.2005.12.008. - DOI - PubMed
    1. Crossman PT, Khan RJ, MacDowell A, Gardner AC, Reddy NS, Keene GS. A survey of the treatment of displaced intracapsular femoral neck fractures in the UK. Injury. 2002;33:383–6. doi: 10.1016/S0020-1383(02)00002-5. - DOI - PubMed
    1. Bhattacharyya T, Koval KJ. Unipolar versus bipolar hemiarthroplasty for femoral neck fractures: is there a difference? J Orthop Trauma. 2009;23:426–7. doi: 10.1097/BOT.0b013e3181adb057. - DOI - PubMed
    1. Gilbert MS, Capozzi J. Unipolar or bipolar prosthesis for the displaced intracapsular hip fracture? An unanswered question. Clin Orthop Relat Res. 1998;353:81–5. doi: 10.1097/00003086-199808000-00010. - DOI - PubMed