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. 2022 Feb 14;2(2):CD013410.
doi: 10.1002/14651858.CD013410.pub2.

Arthroplasties for hip fracture in adults

Sharon R Lewis  1 , Richard Macey  2 , Martyn J Parker  3 , Jonathan A Cook  2 , Xavier L Griffin  1   4
Affiliations

Arthroplasties for hip fracture in adults

Sharon R Lewis et al. Cochrane Database Syst Rev. .

Abstract

Background: Hip fractures are a major healthcare problem, presenting a huge challenge and burden to individuals and healthcare systems. The number of hip fractures globally is rising rapidly. The majority of hip fractures are treated surgically. This review evaluates evidence for types of arthroplasty: hemiarthroplasties (HAs), which replace part of the hip joint; and total hip arthroplasties (THAs), which replace all of it.

Objectives: To determine the effects of different designs, articulations, and fixation techniques of arthroplasties for treating hip fractures in adults.

Search methods: We searched CENTRAL, MEDLINE, Embase, seven other databases and one trials register in July 2020.

Selection criteria: We included randomised controlled trials (RCTs) and quasi-RCTs comparing different arthroplasties for treating fragility intracapsular hip fractures in older adults. We included THAs and HAs inserted with or without cement, and comparisons between different articulations, sizes, and types of prostheses. We excluded studies of people with specific pathologies other than osteoporosis and with hip fractures resulting from high-energy trauma.

Data collection and analysis: We used standard methodological procedures expected by Cochrane. We collected data for seven outcomes: activities of daily living, functional status, health-related quality of life, mobility (all early: within four months of surgery), early mortality and at 12 months after surgery, delirium, and unplanned return to theatre at the end of follow-up.

Main results: We included 58 studies (50 RCTs, 8 quasi-RCTs) with 10,654 participants with 10,662 fractures. All studies reported intracapsular fractures, except one study of extracapsular fractures. The mean age of participants in the studies ranged from 63 years to 87 years, and 71% were women. We report here the findings of three comparisons that represent the most substantial body of evidence in the review. Other comparisons were also reported, but with many fewer participants. All studies had unclear risks of bias in at least one domain and were at high risk of detection bias. We downgraded the certainty of many outcomes for imprecision, and for risks of bias where sensitivity analysis indicated that bias sometimes influenced the size or direction of the effect estimate. HA: cemented versus uncemented (17 studies, 3644 participants) There was moderate-certainty evidence of a benefit with cemented HA consistent with clinically small to large differences in health-related quality of life (HRQoL) (standardised mean difference (SMD) 0.20, 95% CI 0.07 to 0.34; 3 studies, 1122 participants), and reduction in the risk of mortality at 12 months (RR 0.86, 95% CI 0.78 to 0.96; 15 studies, 3727 participants). We found moderate-certainty evidence of little or no difference in performance of activities of daily living (ADL) (SMD -0.03, 95% CI -0.21 to 0.16; 4 studies, 1275 participants), and independent mobility (RR 1.04, 95% CI 0.95 to 1.14; 3 studies, 980 participants). We found low-certainty evidence of little or no difference in delirium (RR 1.06, 95% CI 0.55 to 2.06; 2 studies, 800 participants), early mortality (RR 0.95, 95% CI 0.80 to 1.13; 12 studies, 3136 participants) or unplanned return to theatre (RR 0.70, 95% CI 0.45 to 1.10; 6 studies, 2336 participants). For functional status, there was very low-certainty evidence showing no clinically important differences. The risks of most adverse events were similar. However, cemented HAs led to less periprosthetic fractures intraoperatively (RR 0.20, 95% CI 0.08 to 0.46; 7 studies, 1669 participants) and postoperatively (RR 0.29, 95% CI 0.14 to 0.57; 6 studies, 2819 participants), but had a higher risk of pulmonary embolus (RR 3.56, 95% CI 1.26 to 10.11, 6 studies, 2499 participants). Bipolar HA versus unipolar HA (13 studies, 1499 participants) We found low-certainty evidence of little or no difference between bipolar and unipolar HAs in early mortality (RR 0.94, 95% CI 0.54 to 1.64; 4 studies, 573 participants) and 12-month mortality (RR 1.17, 95% CI 0.89 to 1.53; 8 studies, 839 participants). We are unsure of the effect for delirium, HRQoL, and unplanned return to theatre, which all indicated little or no difference between articulation, because the certainty of the evidence was very low. No studies reported on early ADL, functional status and mobility. The overall risk of adverse events was similar. The absolute risk of dislocation was low (approximately 1.6%) and there was no evidence of any difference between treatments. THA versus HA (17 studies, 3232 participants) The difference in the risk of mortality at 12 months was consistent with clinically relevant benefits and harms (RR 1.00, 95% CI 0.83 to 1.22; 11 studies, 2667 participants; moderate-certainty evidence). There was no evidence of a difference in unplanned return to theatre, but this effect estimate includes clinically relevant benefits of THA (RR 0.63, 95% CI 0.37 to 1.07, favours THA; 10 studies, 2594 participants; low-certainty evidence). We found low-certainty evidence of little or no difference between THA and HA in delirium (RR 1.41, 95% CI 0.60 to 3.33; 2 studies, 357 participants), and mobility (MD -0.40, 95% CI -0.96 to 0.16, favours THA; 1 study, 83 participants). We are unsure of the effect for early functional status, ADL, HRQoL, and mortality, which indicated little or no difference between interventions, because the certainty of the evidence was very low. The overall risks of adverse events were similar. There was an increased risk of dislocation with THA (RR 1.96, 95% CI 1.17 to 3.27; 12 studies, 2719 participants) and no evidence of a difference in deep infection.

Authors' conclusions: For people undergoing HA for intracapsular hip fracture, it is likely that a cemented prosthesis will yield an improved global outcome, particularly in terms of HRQoL and mortality. There is no evidence to suggest a bipolar HA is superior to a unipolar prosthesis. Any benefit of THA compared with hemiarthroplasty is likely to be small and not clinically appreciable. We encourage researchers to focus on alternative implants in current clinical practice, such as dual-mobility bearings, for which there is limited available evidence.

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Conflict of interest statement

SL has no known conflicts of interest. RM has no known conflicts of interest. MP has received expenses and honoraria from a number of commercial companies and organisations for giving lectures on different aspects of hip fracture treatment. In addition, he has received royalties from BBrawn Ltd related to the design and development of an implant used for the internal fixation of intracapsular hip fractures. He remained independent of study selection decisions, risk of bias assessment, and any data extraction of any of the studies on which he is an author, co‐applicant, or has had an advisory role. JC remained independent of study selection decisions for ongoing studies. XG is funded by a National Institute for Health Research Clinician Scientist Grant. Further funding from industry and charitable grants are and have been made available to his institution. All decisions relating to the design, conduct, analysis, write‐up and publication of research are independent of these funding organisations. He has ongoing expert consultancy with several companies; none involve the development of any implant for use in hip fracture care. He remained independent of study selection decisions, risk of bias assessment, and any data extraction of any of the studies on which he is an author, co‐applicant, or has had an advisory role.

Figures

1
1
PRISMA flow diagram
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study. Blank spaces indicate that risk of bias was not conducted because study authors did not report outcomes relevant to these domains.
3
3
Cemented hemiarthroplasty versus uncemented hemiarthroplasty. Funnel plot for early mortality (≤ 4 months), subgrouped by stem design
4
4
Cemented hemiarthroplasty versus uncemented hemiarthroplasty. Funnel plot for mortality at 12 months, subgrouped by stem design
5
5
Bipolar hemiarthroplasty versus unipolar hemiarthroplasty. Forest plot for adverse events related to the implant, fracture, or both
6
6
Total hip arthroplasty versus hemiarthroplasty. Forest plot of functional status at 12 months
1.1
1.1. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 1: ADL (measurement tool not defined)
1.2
1.2. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 2: Functional status (using HHS, range for scores from 0 to 100; higher scores indicate better function)
1.3
1.3. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 3: HRQoL (using EQ‐5D, range of scores from o to 1; higher scores indicate better quality of life)
1.4
1.4. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 4: Mortality (12 months)
1.5
1.5. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 5: Unplanned return to theatre (end of follow‐up)
1.6
1.6. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 6: Pain (using PNRS, range of scores from 0 to 11: lower values indicate less pain)
1.7
1.7. Analysis
Comparison 1: THA: cemented vs uncemented, Outcome 7: Adverse events related to the implant, fracture, or both
2.1
2.1. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 1: Early ADL (≤ 4 months, continuous data)
2.2
2.2. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 2: Early ADL (≤ 4 months, categorical data)
2.3
2.3. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 3: ADL (12 months, continuous data)
2.4
2.4. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 4: ADL (12 months, categorical data)
2.5
2.5. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 5: Late ADL (> 24 months; categorical data)
2.6
2.6. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 6: Delirium (end of follow‐up)
2.7
2.7. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 7: Early functional status (≤ 4 months, continuous data)
2.8
2.8. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 8: Early functional status (≤ 4 months; categorical data)
2.9
2.9. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 9: Early functional status: extracapsular fractures (≤ 4 months. HHS; higher scores indicate better function)
2.10
2.10. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 10: Functional status (12 months; continuous data using HHS, OHS and VELCA; higher scores indicate better function)
2.11
2.11. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 11: Functional status (12 months, categorical data using HHS)
2.12
2.12. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 12: Functional status: extracapsular fractures (12 months. HHS; higher scores indicate improved function)
2.13
2.13. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 13: Late functional status (> 24 months using HHS; higher scores indicate better function)
2.14
2.14. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 14: Early HRQoL (≤ 4 months)
2.15
2.15. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 15: HRQoL (12 months)
2.16
2.16. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 16: Late HRQoL (> 24 months)
2.17
2.17. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 17: Early mobility (≤ 4 months, independent mobility)
2.18
2.18. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 18: Early mobility (≤ 4 months, continuous data)
2.19
2.19. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 19: Early mobility (mean reduction values at ≤ 4 months; higher scores indicate better mobility)
2.20
2.20. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 20: Mobility (12 months, continuous data using different mobility scales; lower scores indicate better mobility)
2.21
2.21. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 21: Mobility (12 months, independent mobility)
2.22
2.22. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 22: Mobility (12 months, dependent on walking aid)
2.23
2.23. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 23: Late mobility (> 24 months)
2.24
2.24. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 24: Late mobility (> 24 months; independent mobility)
2.25
2.25. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 25: Early mortality (≤ 4 months)
2.26
2.26. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 26: Mortality (12 months)
2.27
2.27. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 27: Late mortality (> 24 months)
2.28
2.28. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 28: Unplanned return to theatre (end of follow‐up)
2.29
2.29. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 29: Early pain (≤ 4 months, experiencing no pain)
2.30
2.30. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 30: Early pain (≤ 4 months; mean scores, lower scores indicate less pain)
2.31
2.31. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 31: Pain (12 months, experiencing no pain)
2.32
2.32. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 32: Pain (12 months, using continuous data; lower values indicate less pain)
2.33
2.33. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 33: Pain (12 months; mean reduction values: lower scores indicate less pain)
2.34
2.34. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 34: Late pain (> 24 months, using mean scores; lower scores indicate less pain)
2.35
2.35. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 35: Late pain (> 24 months; experiencing no pain)
2.36
2.36. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 36: Length of hospital stay (days)
2.37
2.37. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 37: Discharge destination (own home)
2.38
2.38. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 38: Adverse events related to the implant, fracture, or both
2.39
2.39. Analysis
Comparison 2: HA: cemented vs uncemented, Outcome 39: Adverse events unrelated to the implant, fracture, or both
3.1
3.1. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 1: Functional status (12 months, using HHS, range of scores from 0 to 100; higher scores indicate better function)
3.2
3.2. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 2: HRQoL (12 months, using SF‐36, range of scores from 0 to 100; higher scores indicate better quality of life)
3.3
3.3. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 3: Early mortality (≤ 4 months)
3.4
3.4. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 4: Mortality (12 months)
3.5
3.5. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 5: Late mortality (> 24 months)
3.6
3.6. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 6: Pain (12 months, using HHS pain scales; higher values indicate less pain)
3.7
3.7. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 7: Pain (> 24 months, using HHS pain scales; higher values indicate less pain)
3.8
3.8. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 8: Unplanned return to theatre (end of follow‐up)
3.9
3.9. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 9: Adverse events related to the implant, fracture, or both
3.10
3.10. Analysis
Comparison 3: Mixed HA and THA: cemented vs uncemented, Outcome 10: Adverse events unrelated to implant, fracture, or both
4.1
4.1. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 1: ADL (12 months)
4.2
4.2. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 2: Delirium/confusion
4.3
4.3. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 3: Functional status (12 months; using different measurement tools; higher scores indicate better function)
4.4
4.4. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 4: Functional status (12 months. HHS; excellent and good)
4.5
4.5. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 5: Functional status (> 24 months. HHS; excellent or good)
4.6
4.6. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 6: Early HRQoL (≤ 4 months)
4.7
4.7. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 7: HRQoL (12 months)
4.8
4.8. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 8: Mobility (Get up and Go Test; in seconds)
4.9
4.9. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 9: Mobility (6 minute walk test; in metres)
4.10
4.10. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 10: Early mortality (≤ 4 months)
4.11
4.11. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 11: Mortality (12 months)
4.12
4.12. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 12: Late mortality (> 24 months)
4.13
4.13. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 13: Unplanned return to theatre (end of follow‐up)
4.14
4.14. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 14: Pain (categorical data; no pain, or mild pain)
4.15
4.15. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 15: Pain (12 months)
4.16
4.16. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 16: Length of hospital stay (days)
4.17
4.17. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 17: Discharge destination: return to preoperative residence
4.18
4.18. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 18: Adverse events related to implant, fracture, or both
4.19
4.19. Analysis
Comparison 4: Bipolar HA vs unipolar HA, Outcome 19: Adverse event unrelated to implant, fracture, or both
5.1
5.1. Analysis
Comparison 5: HA: short stem vs standard stem, Outcome 1: Mobility (24 months)
5.2
5.2. Analysis
Comparison 5: HA: short stem vs standard stem, Outcome 2: Mortality (24 months)
5.3
5.3. Analysis
Comparison 5: HA: short stem vs standard stem, Outcome 3: Pain (24 months)
5.4
5.4. Analysis
Comparison 5: HA: short stem vs standard stem, Outcome 4: Adverse events related to implant, fracture, or both
6.1
6.1. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 1: Delirium
6.2
6.2. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 2: Early HRQoL (≤ 4 months)
6.3
6.3. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 3: Early mobility (freely mobile without aids, or able to walk outdoors with one aid)
6.4
6.4. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 4: Early mortality (≤ 4 months)
6.5
6.5. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 5: Mortality (12 months)
6.6
6.6. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 6: Unplanned return to theatre (end of follow‐up)
6.7
6.7. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 7: Adverse events related to implant, fracture, or both
6.8
6.8. Analysis
Comparison 6: HA: ETS vs Thompson, Outcome 8: Adverse events unrelated to implant, fracture, or both
7.1
7.1. Analysis
Comparison 7: HA: Furlong vs Moore, Outcome 1: Early mortality (≤ 4 months)
7.2
7.2. Analysis
Comparison 7: HA: Furlong vs Moore, Outcome 2: Mortality (12 months)
7.3
7.3. Analysis
Comparison 7: HA: Furlong vs Moore, Outcome 3: Unplanned return to theatre (at end of follow‐up)
7.4
7.4. Analysis
Comparison 7: HA: Furlong vs Moore, Outcome 4: Pain at rest
7.5
7.5. Analysis
Comparison 7: HA: Furlong vs Moore, Outcome 5: Adverse events related to the implant, fracture, or both
8.1
8.1. Analysis
Comparison 8: THA vs HA, Outcome 1: Early ADL (≤ 4 months, using categorical data)
8.2
8.2. Analysis
Comparison 8: THA vs HA, Outcome 2: Early ADL (≤ 4 months; using social mobility scale (lower scores indicate better mobility)
8.3
8.3. Analysis
Comparison 8: THA vs HA, Outcome 3: ADL (12 months, using categorical data)
8.4
8.4. Analysis
Comparison 8: THA vs HA, Outcome 4: ADL (12 months; using different measurement tools; lower scores indicate more independence))
8.5
8.5. Analysis
Comparison 8: THA vs HA, Outcome 5: Late ADL (> 24 months; using Barthel Index, range of scores from 0 to 100; higher scores indicate more independence)
8.6
8.6. Analysis
Comparison 8: THA vs HA, Outcome 6: Delirium
8.7
8.7. Analysis
Comparison 8: THA vs HA, Outcome 7: Early functional status (≤ 4 months)
8.8
8.8. Analysis
Comparison 8: THA vs HA, Outcome 8: Functional status (12 months)
8.9
8.9. Analysis
Comparison 8: THA vs HA, Outcome 9: Functional status (HHS; excellent or good)
8.10
8.10. Analysis
Comparison 8: THA vs HA, Outcome 10: Late functional status (> 24 months; using OHS and HHS; higher scores indicate better function)
8.11
8.11. Analysis
Comparison 8: THA vs HA, Outcome 11: Early HRQoL (≤ 4 months)
8.12
8.12. Analysis
Comparison 8: THA vs HA, Outcome 12: HRQoL (12 months)
8.13
8.13. Analysis
Comparison 8: THA vs HA, Outcome 13: HRQoL (> 24 months. Using SF‐36; higher scores indicate better quality of life)
8.14
8.14. Analysis
Comparison 8: THA vs HA, Outcome 14: Early mobility (≤ 4 months; lower scores indicate better mobility
8.15
8.15. Analysis
Comparison 8: THA vs HA, Outcome 15: Mobility (12 months, using TUG; lower values indicate better mobility)
8.16
8.16. Analysis
Comparison 8: THA vs HA, Outcome 16: Mobility (12 months, using 9‐point mobility scale; lower scores indicate better mobility)
8.17
8.17. Analysis
Comparison 8: THA vs HA, Outcome 17: Mobility (12 months; able to ambulate independently)
8.18
8.18. Analysis
Comparison 8: THA vs HA, Outcome 18: Late mobility (> 24 months; able to ambulate independently)
8.19
8.19. Analysis
Comparison 8: THA vs HA, Outcome 19: Early mortality (≤ 4 months)
8.20
8.20. Analysis
Comparison 8: THA vs HA, Outcome 20: Mortality (12 months)
8.21
8.21. Analysis
Comparison 8: THA vs HA, Outcome 21: Late mortality (> 24 months)
8.22
8.22. Analysis
Comparison 8: THA vs HA, Outcome 22: Unplanned return to theatre (end of follow‐up)
8.23
8.23. Analysis
Comparison 8: THA vs HA, Outcome 23: Length of hospital stay (days)
8.24
8.24. Analysis
Comparison 8: THA vs HA, Outcome 24: Pain (12 months: data not combined; lower scores indicate less pain)
8.25
8.25. Analysis
Comparison 8: THA vs HA, Outcome 25: Late pain (> 24 months)
8.26
8.26. Analysis
Comparison 8: THA vs HA, Outcome 26: Pain (> 24 months: categorical data: no pain)
8.27
8.27. Analysis
Comparison 8: THA vs HA, Outcome 27: Early pain (≤ 4 months: higher scores indicate less pain)
8.28
8.28. Analysis
Comparison 8: THA vs HA, Outcome 28: Discharge destination (own home)
8.29
8.29. Analysis
Comparison 8: THA vs HA, Outcome 29: Discharge destination (geriatric ward)
8.30
8.30. Analysis
Comparison 8: THA vs HA, Outcome 30: Adverse events related to implant, fracture, or both
8.31
8.31. Analysis
Comparison 8: THA vs HA, Outcome 31: Adverse events unrelated to implant, fracture, or both
9.1
9.1. Analysis
Comparison 9: THA: single articulation vs dual‐mobility, Outcome 1: Early functional status (≤ 4 months, using different scales; higher scores indicate better function)
9.2
9.2. Analysis
Comparison 9: THA: single articulation vs dual‐mobility, Outcome 2: Functional status (12 months, using OHS and HHS; higher scores indicate better function)
9.3
9.3. Analysis
Comparison 9: THA: single articulation vs dual‐mobility, Outcome 3: HRQoL (using EQ‐5D, range of scores from 0 to 1; higher scores indicate better quality of life)
9.4
9.4. Analysis
Comparison 9: THA: single articulation vs dual‐mobility, Outcome 4: Mortality (12 months)
9.5
9.5. Analysis
Comparison 9: THA: single articulation vs dual‐mobility, Outcome 5: Adverse events related to the implant, fracture, or both
9.6
9.6. Analysis
Comparison 9: THA: single articulation vs dual‐mobility, Outcome 6: Adverse events unrelated to the implant, fracture, or both
10.1
10.1. Analysis
Comparison 10: THA: short stem vs standard stem, Outcome 1: Functional status (at 24 months; using HHS, range of scores from 0 to 100; higher scores indicate better function)
10.2
10.2. Analysis
Comparison 10: THA: short stem vs standard stem, Outcome 2: Mobility
10.3
10.3. Analysis
Comparison 10: THA: short stem vs standard stem, Outcome 3: Mortality (12 months)
10.4
10.4. Analysis
Comparison 10: THA: short stem vs standard stem, Outcome 4: Pain
10.5
10.5. Analysis
Comparison 10: THA: short stem vs standard stem, Outcome 5: Adverse events related to the implant, fracture, or both
10.6
10.6. Analysis
Comparison 10: THA: short stem vs standard stem, Outcome 6: Adverse events unrelated to the implant, fracture, or both
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Comment in

References

References to studies included in this review

Abdelkhalek 2011 {published data only}
    1. Abdelkhalek M, Abdelwahab M, Ali A M.Bipolar versus fixed-head hip arthroplasty for femoral neck fractures in elderly patients. Strategies in Trauma & Limb Reconstruction 2011;6(1):1-6. [PMID: ] - PMC - PubMed
Baker 2006 {published data only}
    1. Avery PP, Baker RP, Walton MJ, Rooker JC, Squires B, Gargan MF, et al.Total hip replacement and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck: a seven- to ten-year follow-up report of a prospective randomised controlled trial. Journal of Bone and Joint Surgery - British Volume 2011;93(8):1045-8. [PMID: ] - PubMed
    1. Baker RP, Squires B, Gargan MF, Bannister GC.Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial. Journal of Bone & Joint Surgery - American Volume 2006;88(12):2583-9. [PMID: ] - PubMed
    1. Baker RP, Squires B, Gargan MF, Bannister GC.A randomised controlled comparison of total hip arthroplasty and hemiarthroplasty in mobile independent patients with displaced intracapsular femoral neck fracture [abstract]. Journal of Bone and Joint Surgery - British Volume 2006;88:431-2. - PubMed
    1. ISRCTN70736853.A randomised prospective trial comparing unipolar hemiarthroplasty, bipolar hemiarthroplasty and total hip replacement in the treatment of displaced intracapsular femoral neck fractures. www.isrctn.com/ISRCTN70736853 (first received 20 September 2004).
Blomfeldt 2007 {published data only}
    1. Blomfeldt R, Tornkvist H, Eriksson K, Soderqvist A, Ponzer S, Tidermark J.A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. Journal of Bone & Joint Surgery - British Volume 2007;89(2):160-5. [PMID: ] - PubMed
    1. Blomfeldt R, Tornkvist H, Eriksson K, Soderqvist A, Ponzer S, Tidermark J.Bipolar hemiarthroplasty compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial [abstract]. Journal of Bone & Joint Surgery - British Volume 2009;91:169.
    1. Hedbeck CJ, Enocson A, Lapidus G, Blomfeldt R, Tornkvist H, Ponzer S, et al.Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: a concise four-year follow-up of a randomized trial. Journal of Bone & Joint Surgery - American Volume 2011;93(5):445-50. [PMID: ] - PubMed
Brandfoot 2000 {published data only}
    1. Brandfoot T, Faraj AA, Porter P.Cemented versus uncemented Thompson's prosthesis: a randomised prospective functional outcome study. Injury 2000;31:280-1.
Cadossi 2013 {published data only}
    1. Cadossi M, Chiarello E, Savarino L, Tedesco G, Baldini N, Faldini C, et al.A comparison of hemiarthroplasty with a novel polycarbonate-urethane acetabular component for displaced intracapsular fractures of the femoral neck: a randomised controlled trial in elderly patients. Bone & Joint Journal 2013;95(5):609-15. Erratum in: Bone & Joint Journal 2013; 95-B(11):1582. [PMID: ] - PubMed
    1. Cadossi M, Chiarello E, Savarino L, Tedesco G, Baldini N, Faldini C, et al.Erratum: A comparison of hemiarthroplasty with a novel polycarbonate- urethane acetabular component for displaced intracapsular fractures of the femoral neck: a randomised controlled trial in elderly patients. Bone & Joint Journal 2013;95(11):1582. Erratum for: Bone & Joint Journal 2013; 95B: 609-15. - PubMed
Calder 1995 {published data only}
    1. Calder SJ, Anderson GH, Harper WM, Jagger C, Gregg PJ.A subjective health indicator for follow-up. A randomised trial after treatment of displaced intracapsular hip fractures. Journal of Bone and Joint Surgery - British Volume 1995;77(3):494-6. [PMID: ] - PubMed
Calder 1996 {published data only}
    1. Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ.Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians: a randomised prospective study. Journal of Bone and Joint Surgery - British Volume 1996;78(3):391-4. [PMID: ] - PubMed
Cao 2017 {published data only}
    1. Cao X, Kong X, Li A.Auxiliary biological cemented femoral stem was effective in treating elderly patients with intertrochanteric fracture. Biomedical Research (India) 28;9:4071-5. [ISSN: 0970-938X]
Chammout 2017 {published data only}
    1. Chammout G, Muren O, Boden H, Salemyr M, Skoldenberg O.Cemented compared to uncemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly: study protocol for a single-blinded, randomized controlled trial (CHANCE-trial). BMC Musculoskeletal Disorders 2016;17(1):398. [PMID: ] - PMC - PubMed
    1. Chammout G, Muren O, Laurencikas E, Boden H, Kelly-Pettersson P, Sjoo H, et al.More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly. Acta Orthopaedica 2017;88(2):145-51. [PMID: ] - PMC - PubMed
    1. NCT02247791.Study of prosthesis choice in older patients with a dislocated femoral neck fracture of the hip. clinicaltrials.gov/ct2/show/NCT02247791 (first received 25 September 2014).
Chammout 2019 {published data only}
    1. Chammout G, Kelly-Pettersson P, Hedbeck C-J, Stark A, Mukka S, Skoldenberg O.HOPE-Trial: Hemiarthroplasty compared with total hip arthroplasty for displaced femoral neck fractures in octogenarians: a randomized controlled trial. Journal of Bone and Joint Surgery - American Volume 2019;4((2) e0059):1-9. [PMID: ] - PMC - PubMed
    1. NCT02246335.Hemiarthroplasty compared to total hip arthroplasty for displaced femoral neck fractures in the elderly. A randomised controlled trial. clinicaltrials.gov/ct2/show/NCT02246335 (first received 22 September 2014).
    1. Skoldenberg O, Chammout G, Mukka S, Muren O, Nasell H, Hedbeck CJ, et al.HOPE-trial: hemiarthroplasty compared to total hip arthroplasty for displaced femoral neck fractures in the elderly-elderly, a randomized controlled trial. BMC Musculoskeletal Disorders 2015;16:307. [PMID: ] - PMC - PubMed
Cornell 1998 {published data only}
    1. Cornell CN, Levine D, O'Doherty J, Lyden J.Unipolar versus bipolar hemiarthroplasty for the treatment of femoral neck fractures in the elderly. Clinical Orthopaedics & Related Research 1998;348:67-71. [PMID: ] - PubMed
Davison 2001 {published data only}
    1. Calder SJ, Anderson GH, Gregg PJ.Bipolar hemiarthroplasty for displaced intracapsular hip fractures: a randomised prospective trial [abstract]. Journal of Bone and Joint Surgery - British Volume 1995;77:214. - PubMed
    1. Calder SJ, Anderson GH, Harper WM, Gregg PJ.The use of bipolar hemi-arthroplasty in intracapsular hip fracture - a prospective randomised trial [abstract]. Journal of Bone and Joint Surgery - British Volume 1995;77(1):no pagination.
    1. Davison J, Harper WM, Gregg PJ.Which treatment for the displaced fractures of the femoral neck? A prospective randomised comparison of three surgical procedures [abstract]. Journal of Bone and Joint Surgery 1997;79(2):243-4.
    1. Davison JN, Calder SJ, Anderson GH, Ward G, Jagger C, Harper WM, et al.Treatment for displaced intracapsular fracture of the proximal femur. Journal of Bone and Joint Surgery 2001;83(2):206-12. [PMID: ] - PubMed
DeAngelis 2012 {published data only}
    1. DeAngelis JP, Ademi A, Staff I, Lewis CG.Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: a prospective randomized trial with early follow-up. Journal of Orthopaedic Trauma 2012;26(3):135-40. [PMID: ] - PubMed
    1. NCT01114646.Functional status, morbidity and mortality in cemented versus uncemented hemiarthroplasty for subcapital hip fractures: a prospective randomised trial. clinicaltrials.gov/ct2/show/results/NCT01114646 (first received 3 May 2010).
Dorr 1986 {published data only}
    1. Dorr LD, Glousman R, Hoy AL, Vanis R, Chandler R.Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. Journal of Arthroplasty 1986;1(1):21-8. [PMID: ] - PubMed
Emery 1991 {published data only}
    1. Emery RJ, Broughton NS, Desai K, Bulstrode CJ, Thomas TL.Bipolar hemiarthroplasty for subcapital fracture of the femoral neck. A prospective randomised trial of cemented Thompson and uncemented Moore stems. Journal of Bone and Joint Surgery - British Volume 1991;73(2):322-4. [PMID: ] - PubMed
Fernandez 2022 {published data only}
    1. Fernandez MA, Achten J, Lerner RG, Mironov K, Parsons N, Dritsaki M, et al.Randomised controlled trial comparing hydroxyapatite coated uncemented hemiarthroplasty with cemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: a protocol for the WHITE 5 study. BMJ Open 2019;9(12):e033957. [PMID: ] - PMC - PubMed
    1. Fernandez MA, Achten J, Parsons N, Griffin XL, Png M-E, Gould J, et al.Cemented or uncemented hemiarthroplasty for intracapsular hip fracture. New England Journal of Medicine 2022;386:521-30. - PubMed
    1. ISRCTN18393176.A randomised controlled trial to compare contemporary un-cemented hemiarthroplasty with the standard-of-care cemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures. www.isrctn.com/ISRCTN18393176 (first received 13 March 2017).
Figved 2009 {published data only}
    1. Figved W, Opland V, Frihagen F, Jervidalo T, Madsen JE, Nordsletten L.Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures. Clinical Orthopaedics & Related Research 2009;467(9):2426-35. [PMID: ] - PMC - PubMed
    1. Langslet E, Frihagen F, Opland V, Madsen JE, Nordsletten L, Figved W.Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: 5-year followup of a randomized trial. Clinical Orthopaedics & Related Research 2014;472(4):1291-9. [PMID: ] - PMC - PubMed
    1. NCT00491673.A prospective randomised trial of uncemented versus cemented hemiarthroplasty for displaced femoral neck fractures. clinicaltrials.gov/ct2/show/record/NCT00491673 (first received 25 June 2007).
Figved 2018 {published data only}
    1. Figved W, Svenoy S, Rohrl SM, Dahl J, Nordsletten L, Frihagen F.Higher cartilage wear in unipolar than bipolar hemiarthroplasties of the hip at 2 years: a randomized controlled radiostereometric study in 19 fit elderly patients with femoral neck fractures. Acta Orthopaedica 2018;89(5):503-8. [PMID: ] - PMC - PubMed
    1. NCT00746876.Unipolar or bipolar hemiarthroplasty in the treatment of displaced femoral neck fractures. A randomised trial of RSA measurements of acetabular wear. clinicaltrials.gov/ct2/show/NCT00746876 (first received 4 September 2008).
Griffin 2016 {published data only}
    1. Griffin XL, McArthur J, Achten J, Parsons N, Costa ML.The Warwick Hip Trauma Evaluation Two -an abridged protocol for the WHiTE Two Study: an embedded randomised trial comparing the dual-mobility with polyethylene cups in hip arthroplasty for fracture. Bone & Joint Research 2013;2(10):210-3. [PMID: ] - PMC - PubMed
    1. Griffin XL, Parsons N, Achten J, Costa ML.A randomised feasibility study comparing total hip arthroplasty with and without dual mobility acetabular component in the treatment of displaced intracapsular fractures of the proximal femur : the Warwick Hip Trauma Evaluation Two: WHiTE Two. The Bone & Joint Journal 2016;98(11):1431-5. [PMID: ] - PubMed
    1. ISRCTN90544391.A randomised controlled trial comparing total hip replacement with and without a dual mobility cup in the treatment of displaced intracapsular fractures of the proximal femur. www.isrctn.com/ISRCTN90544391 (first received 9 April 2013).
Harper 1994 {published data only}
    1. Anderson GH, Dias JJ, Hoskinson J, Harper WM.A randomized study of the use of bone cement with Thompson's prosthesis in the treatment of intracapsular fractures of the femoral neck [abstract]. Journal of Bone and Joint Surgery - British Volume 1992;74(2):132-3.
    1. Harper WM.Treatment of intracapsular proximal femoral fractures. A prospective randomised trial comparing cemented and uncemented Thompson hemiarthroplasty in the treatment of displaced intracapsular proximal femoral fractures [dissertation]. Leicester, UK: University of Leicester, 1994.
HEALTH 2019 {published data only}
    1. Bhandari M, Devereaux PJ, Einhorn TA, Thabane L, Schemitsch EH, Koval KJ, et al, Investigators Health.Hip fracture evaluation with alternatives of total hip arthroplasty versus hemiarthroplasty (HEALTH): protocol for a multicentre randomised trial. BMJ Open 2015;5(2):e006263. [PMID: ] - PMC - PubMed
    1. Health Investigators.Total hip arthroplasty or hemiarthroplasty for hip fracture. New England Journal of Medicine 2019;381(23):2199-2208. [PMID: ] - PubMed
    1. NTR1623.Hip fracture evaluation with alternatives of total hip arthroplasty versus hemi-arthroplasty (HEALTH): a multi-centre randomised trial comparing total hip arthroplasty and hemi-arthroplasty on revision surgery and quality of life in patients with displaced femoral neck fractures. www.trialregister.nl/trial/685 (first received 12 January 2009).
Hedbeck 2011 {published data only}
    1. Hedbeck CJ, Blomfeldt R, Lapidus G, Tornkvist H, Ponzer S, Tidermark J.Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures: a randomised, controlled trial. International Orthopaedics 2011;35(11):1703-11. [PMID: ] - PMC - PubMed
    1. Inngul C, Hedbeck CJ, Blomfeldt R, Lapidus G, Ponzer S, Enocson A.Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures: a four-year follow-up of a randomised controlled trial. International Orthopaedics 2013;37(12):2457-64. [PMID: ] - PMC - PubMed
Inngul 2015 {published data only}
    1. Barenius B, Inngul C, Alagic Z, Enocson A.A randomized controlled trial of cemented versus cementless arthroplasty in patients with a displaced femoral neck fracture. Bone & Joint Journal 2018;100(8):1087-93. [PMID: ] - PubMed
    1. Inngul C, Blomfeldt R, Ponzer S, Enocson A.Cemented versus uncemented arthroplasty in patients with a displaced fracture of the femoral neck: a randomised controlled trial. Bone & Joint Journal 2015;97(11):1475-80. [PMID: ] - PubMed
    1. NCT01798472.Cemented versus uncemented arthroplasty in elderly patients with displaced femoral neck fractures: a randomized controlled trial. clinicaltrials.gov/ct2/show/record/NCT01798472 (first received 25 February 2013).
Iorio 2019 {published data only}
    1. Iorio R, Iannotti F, Mazza D, Speranza A, Massafra C, Guzzini M, et al.Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial. SICOT-J 5;38:1-4. [PMID: ] - PMC - PubMed
Jeffcote 2010 {published data only}
    1. Jeffcote B, Li MG, Barnet-Moorcroft A, Wood D, Nivbrant B.Roentgen stereophotogrammetric analysis and clinical assessment of unipolar versus bipolar hemiarthroplasty for subcapital femur fracture: a randomized prospective study. ANZ Journal of Surgery 2010;80(4):242-6. [PMID: ] - PubMed
Kanto 2014 {published data only}
    1. Kanto K, Sihvonen R, Eskelinen A, Laitinen M.Uni- and bipolar hemiarthroplasty with a modern cemented femoral component provides elderly patients with displaced femoral neck fractures with equal functional outcome and survivorship at medium-term follow-up. Archives of Orthopaedic & Trauma Surgery 2014;134(9):1251-9. [PMID: ] - PubMed
Keating 2006 {published data only}
    1. ISRCTN32884890.Scottish trial of arthroplasty or reduction for subcapital fractures (STARS). www.isrctn.com/ISRCTN32884890 (first received 25 April 2003).
    1. Keating JF, Grant A, Masson M, Scott NW, Forbes JF.Displaced intracapsular hip fractures in fit, older people: a randomised comparison of reduction and fixation, bipolar hemiarthroplasty and total hip arthroplasty. Health Technology Assessment 2005;9(41):iii-iv, ix. [PMID: ] - PubMed
    1. Keating JF, Grant A, Masson M, Scott NW, Forbes JF.Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. Journal of Bone and Joint Surgery - American Volume 2006;88(2):249-60. [PMID: ] - PubMed
Kim 2012 {published data only}
    1. Kim YH, Oh JH.A comparison of a conventional versus a short, anatomical metaphyseal-fitting cementless femoral stem in the treatment of patients with a fracture of the femoral neck. Journal of Bone and Joint Surgery - British Volume 2012;94(6):774-81. [PMID: ] - PubMed
Lim 2020 {published data only}
    1. Lim YJ, Park HJ, Lee YK, Ha YC, Koo KH.Comparison of bone preservation in elderly patients with femoral neck fracture after bipolar hemiarthroplasty using shorter femoral stem and standard femoral stem. Indian Journal of Orthopaedics 2020;54(6):868-78. [PMID: ] - PMC - PubMed
Livesley 1993 {published data only}
    1. Livesley PJ, Srivastiva VM, Needoff M, Prince HG, Moulton AM.Use of a hydroxyapatite-coated hemiarthroplasty in the management of subcapital fractures of the femur. Injury 1993;24(4):236-40. [PMID: ] - PubMed
Macaulay 2008 {published data only}
    1. Macaulay W, Nellans K, Garvin K, Iorio R, Healy W, Teeny S, et al, Dfacto Consortiuim.Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty: Functional outcomes in the treatment of displaced femoral neck fractures. Journal of Arthroplasty 2006;17:S238-9. - PubMed
    1. Macaulay W, Nellans KW, Garvin KL, Iorio R, Healy WL, Rosenwasser MP, et al, Dfacto Consortium.Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures: winner of the Dorr Award. Osteoporosis International 2008;23(6):2-8. [PMID: ] - PubMed
    1. Macaulay W, Nellans KW, Iorio R, Garvin KL, Healy WL, Rosenwasser MP, Consortium Dfacto.Total hip arthroplasty is less painful at 12 months compared with hemiarthroplasty in treatment of displaced femoral neck fracture. HSS Journal 2008;4(1):48-54. [PMID: ] - PMC - PubMed
    1. Nellans KW, Parsley BS, Teeny SM, Healy WL, Yoon, RS, Greisberg JK.RCT comparing hemiarthroplasty to THA in treating displaced femoral neck fractures. In: American Academy of Orthopaedic Surgeons 75th Annual Meeting; 2008 Mar 5-9; San Francisco (CA). 2008.
Malhotra 1995 {published data only}
    1. Malhotra R, Arya R, Bhan S.Bipolar hemiarthroplasty in femoral neck fractures. Archives of Orthopaedic & Trauma Surgery 1995;114(2):79-82. [PMID: ] - PubMed
Moerman 2017 {published data only}
    1. Moerman S, Mathijssen NM, Niesten DD, Riedijk R, Rijnberg WJ, Koeter S, et al.More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up. BMC Musculoskeletal Disorders 2017;18(1):169. [PMID: ] - PMC - PubMed
    1. NTR1508.Cemented versus non-cemented hemiarthroplasty of the hip as a treatment for a displaced femoral neck fracture; a multi center randomised trial. www.trialregister.nl/trial/1447 (first received 27 October 2008).
Moroni 2002 {published data only}
    1. Moroni A, Pegreffi F, Romagnoli M, Giannini S.Cemented vs uncemented fixation of femoral neck fractures in osteoporotic patients. A prospective randomized study [abstract]. Hip international 2002;12(2):245-6.
    1. Moroni A, Pegreffi F, Romagnoli M, Hoang-Kim A, Tesei F, Giannini S.Result in osteoporotic femoral neck fractures treated with cemented versus uncemented hip arthroplasty (Abstract). Journal of Bone and Joint Surgery - British Volume 2009;91:167.
Mouzopoulos 2008 {published data only}
    1. Mouzopoulos G, Stamatakos M, Arabatzi H, Vasiliadis G, Batanis G, Tsembeli A, et al.The four-year function results after a displaced subcapital fracture treated with three different surgical options. International Orthopaedics 2008;32(3):367-73. [PMID: ] - PMC - PubMed
Movrin 2020 {published data only}
    1. Movrin I.Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A randomized controlled trial with two years follow-up. Acta Orthopaedica et Traumatoligica Turcica 2020;54(1):83-8. [PMID: ] - PMC - PubMed
Parker 2010c {published data only}
    1. Cumming D, Parker M.Randomised trial of cemented versus uncemented hemiarthroplasty for displaced intracapsular fractures. Orthopaedic Proceedings 2012;94-B:Supp III.
    1. Haleem S, Pryor GA, Parker MJ.Randomised controlled trial of cemented versus uncemented hemiarthroplasty for displaced intracapsular fractures. Journal of Bone and Joint Surgery - British Volume 2008;90:535.
    1. Parker M, Cumming D.Randomised trial of cemented versus uncemented hemiarthroplasty for displaced intracapsular fractures. In: British Orthopaedic Association Annual Congress; 2006 Sep 26-29; Glasgow (UK). 2006.
    1. Parker MJ, Pryor G, Gurusamy K.Cemented versus uncemented hemiarthroplasty for intracapsular hip fractures: a randomised controlled trial in 400 patients. Journal of Bone & Joint Surgery - British Volume 2010;92(1):116-22. [PMID: ] - PubMed
Parker 2012 {published data only}
    1. ISRCTN04635269.Randomised trial of hip fractures treated with two different types of hip replacements. www.isrctn.com/ISRCTN04635269 (first received 28/09/2007).
    1. Parker MJ.Cemented Thompson hemiarthroplasty versus cemented Exeter Trauma Stem (ETS) hemiarthroplasty for intracapsular hip fractures: a randomised trial of 200 patients. Injury 2012;43(6):807-10. [PMID: ] - PubMed
Parker 2019 {published data only}
    1. NCT02998359.Randomised controlled trial of hemiarthroplasty versus total hip replacement for intracapsular hip fractures. clinicaltrials.gov/ct2/show/study/NCT02998359 (first received 20 December 2016).
    1. Parker M, Cawley S.Treatment of the displaced intracapsular fracture for the 'fitter' elderly patients: a randomised trial of total hip arthroplasty versus hemiarthroplasty for 105 patients. Injury 2019;50(11):2009-13. [PMID: ] - PubMed
Parker 2020 {published data only}
    1. NCT02998034.Randomised controlled trial of cemented hemiarthroplasty versus uncemented Furlong hemiarthroplasty. clinicaltrials.gov/ct2/show/record/NCT02998034 (first received 16 December 2016).
    1. Parker M, Cawley S.Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip: a randomized trial of 400 patients. The Bone and Joint Journal 2020;102(B1):11-16. [PMID: ] - PubMed
Patel 2008 {published data only}
    1. Patel N, Brijlall S.Bipolar versus unipolar for displaced intracapsular hip fractures - a preliminary report [abstract]. Journal of Bone and Joint Surgery - British Volume 2008;90:473.
Raia 2003 {published data only}
    1. Raia FJ, Chapman CB, Herrera MF, Schweppe MW, Michelsen CB, Rosenwasser MP.Unipolar or bipolar hemiarthroplasty for femoral neck fractures in the elderly? Clinical Orthopaedics & Related Research 2003;414:259-65. [PMID: ] - PubMed
    1. Schweppe MW, Vitale MG, Yaron I, Herrera MF, Sollano JA, Michelsen CB, et al.Randomized evaluation of bipolar versus unipolar hemiarthroplasty for displaced femoral neck fractures in the elderly: preliminary results. Orthopaedic Trauma Association Annual Meeting 1998;25(11):ota.org/sites/files/legacy_abstracts/ota98/otapa/OTA98511.htm.
Rashed 2020 {published data only}
    1. Rashed RA, Sevenoaks H, Choudry QA, Kasem MS, Elkhadrawe TA, Eldakhakhny MM.Comparison of functional outcome of cemented total hip replacement versus cemented dual-mobility cup total hip replacement for the management of displaced femoral neck fractures in the active elderly patients. HIP International 2020;March(4):1120700020910414. [PMID: ] - PubMed
Ravikumar 2000 {published data only}
    1. Ravikumar KJ, Marsh G.Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur--13 year results of a prospective randomised study. Injury 2000;31(10):793-7. [PMID: ] - PubMed
    1. Skinner P, Riley D, Ellery J, Beaumont A, Coumine R, Shafighian B.Displaced subcapital fractures of the femur: a prospective randomized comparison of internal fixation, hemiarthroplasty and total hip replacement. Injury 1989;20(5):291-3. [PMID: ] - PubMed
Rehman 2014 {published data only}
    1. Rehman ur M, Imran M, Kang TA.Functional outcome of cemented versus uncemented hemiarthroplasty for intracapsular hip fractures. Medical Forum Monthly 2014;25(1):44-8. [PMID: ]
Ren 2017 {published data only}
    1. Ren CG, Gao Y.Comparison of total hip arthroplasty and hemiarthroplasty in elderly patients with femoral neck fracture. Biomedical Research (India) 2017;28(16):7127-30.
Sadr 1977 {published data only}
    1. Sadr B, Arden GP.A comparison of the stability of proplast-coated and cemented Thompson prostheses in the treatment of subcapital femoral fractures. Injury 1977;8(3):234-7. [PMID: ] - PubMed
Santini 2005 {published data only}
    1. Santini S, Rebeccato A, Bolgan I, Turi G.Hip fractures in elderly patients treated with bipolar hemiarthroplasty: comparison between cemented and cementless implants. Journal of Orthopaedics & Traumatology 2005;6(2):80-7. [DOI: 10.1007/s10195-005-0086-5] - DOI
Sharma 2016 {published data only}
    1. Sharma V, Awasthi B, Kumar K, Kohli N, Katoch P.Outcome analysis of hemiarthroplasty vs. total hip replacement in displaced femoral neck fractures in the elderly. Journal of Clinical and Diagnostic Research 2016;10(5):RC11-3. [PMID: ] - PMC - PubMed
Sims 2018 {published data only}
    1. ISRCTN39085558.The World Hip Trauma Evaluation Study 3: hemiarthroplasty evaluation multi-centre investigation. www.isrctn.com/ISRCTN39085558 (first received 23 September 2009).
    1. Sims AL, Parsons N, Achten J, Griffin XL, Costa ML, Reed MR, Cornet trainee collaborative.A randomized controlled trial comparing the Thompson hemiarthroplasty with the Exeter polished tapered stem and Unitrax modular head in the treatment of displaced intracapsular fractures of the hip. Bone & Joint Journal 2018;100(3):352-60. [PMID: ] - PMC - PubMed
    1. Sims AL, Parsons N, Achten J, Griffin XL, Costa ML, Reed MR.The World Hip Trauma Evaluation Study 3. Hemiarthroplasty evaluation by multicentre investigation - WHiTE 3: HEMI - An abridged protocol. Bone and Joint Research 2016;5(1):18-25. [PMID: ] - PMC - PubMed
Sonaje 2017 {published data only}
    1. Sonaje JC, Meena PK, Bansiwal RC, Bobade SS.Comparison of functional outcome of bipolar hip arthroplasty and total hip replacement in displaced femoral neck fractures in elderly in a developing country: a 2-year prospective study. European Journal of Orthopaedic Surgery & Traumatologie 2017;13:13. [PMID: ] - PubMed
Sonne‐Holm 1982 {published data only}
    1. Sonne-Holm S, Walter S, Jensen JS.Moore hemi-arthroplasty with and without bone cement in femoral neck fractures. A clinical controlled trial. Acta Orthopaedica Scandinavica 1982;53(6):953-6. [PMID: ] - PubMed
Stoffel 2013 {published data only}
    1. Stoffel KK, Nivbrant B, Headford J, Nicholls RL, Yates PJ.Does a bipolar hemiprosthesis offer advantages for elderly patients with neck of femur fracture? A clinical trial with 261 patients. ANZ Journal of Surgery 2013;83(4):249-54. [PMID: ] - PubMed
Talsnes 2013 {published data only}
    1. Talsnes O, Hjelmstedt F, Pripp AH, Reikeras O, Dahl OE.No difference in mortality between cemented and uncemented hemiprosthesis for elderly patients with cervical hip fracture. A prospective randomized study on 334 patients over 75 years. Archives of Orthopaedic & Trauma Surgery 2013;133(6):805-9. [PMID: ] - PubMed
Taylor 2012 {published data only}
    1. ACTRN12609000367246.A randomised clinical trial of pain and mobility folllowing cemented vs uncemented hemiarthroplasty in elderly patients with displaced subcapital neck of femur fracture. anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12609000367246 (first received 10 February 2009).
    1. Taylor F, Wright M, Zhu M.Hemiarthroplasty of the hip with and without cement: a randomized clinical trial. Journal of Bone & Joint Surgery - American Volume 2012;94(7):577-83. [PMID: ] - PubMed
Van den Bekerom 2010 {published data only}
    1. Tol MC, Van den Bekerom MP, Sierevelt IN, Hilverdink EF, Raaymakers EL, Goslings JC.Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial. Bone & Joint Journal 2017;99(2):250-4. [PMID: ] - PubMed
    1. Van den Bekerom MP, Hilverdink EF, Sierevelt IN, Reuling EM, Schnater JM, et al.A comparison of hemiarthroplasty with total hip replacement for displaced intracapsular fracture of the femoral neck: a randomised controlled multicentre trial in patients aged 70 years and over. Bone & Joint Journal - British Version 2010;92(10):1422-8. [PMID: ] - PubMed
Vidovic 2013 {published data only}
    1. Vidovic D, Matejcic A, Punda M, Ivica M, Tomljenovic M, Bekavac-Beslin M, et al.Periprosthetic bone loss following hemiarthroplasty: a comparison between cemented and cementless hip prosthesis. Injury 2013;44:S62-6. [PMID: ] - PubMed
    1. Vidovic D, Punda M, Darabos N, Bekavac-Beslin M, Bakota B, Matejcic A.Regional bone loss following femoral neck fracture: A comparison between cemented and cementless hemiarthroplasty. Injury 2015;46:S52-6. [PMID: ] - PubMed
Xu 2017 {published data only}
    1. Xu F, Ke R, Gu Y, Qi W.Bipolar hemiarthroplasty vs. total hip replacement in elderly. International Journal of Clinical and Experimental Medicine 2017;10(5):7911-20. [CORPUS ID: 53049671]

References to studies excluded from this review

Aydin 2009 {published data only}
    1. Aydin N, Bezer M, Akgulle AH, Saygi B, Kocaoglu B, Guven O.Comparison of distal and proximal centralising devices in hip arthroplasty. International Orthopaedics 2009;33(4):945-8. - PMC - PubMed
ISRCTN42349821 {published data only}
    1. ISRCTN42349821.Comparing outcomes of fractured neck of femur patients treated with Thompsons hemiarthroplasty versus Exeter Trauma Stem. www.isrctn.com/ISRCTN42349821 (first received 28 July 2014).
Karpman 1992 {published data only}
    1. Karpman RR, Lee TK, Moore BM.Austin-Moore versus Bipolar hemiarthroplasty for displaced femoral neck fractures: a randomized prospective study [abstract]. Orthopaedic Transactions 1992;16:no pagination.
Kavcic 2006 {published data only}
    1. Kavcic G, Hudoklin P, Mikek M, Hussein M.Hemiarthroplasty versus total arthroplasty for treatment of femoral neck fractures. European Journal of Trauma 2006;32:24.
Rosen 1992 {published data only}
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Somashekar 2013 {published data only}
    1. Somashekar, Krishna SV, Murthy JS.Treatment of femoral neck fractures: unipolar versus bipolar hemiarthroplasty. Malaysian Orthopaedic Journal 2013;7(2):6-11. [PMID: ] - PMC - PubMed
Stock 1997 {published data only}
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    1. Van Thiel PH, Snellen JP, Jansen WB, Van de Slikke W.Moore prosthesis versus bipolar Bateman prosthesis: a prospective randomised clinical study. Journal of Bone and Joint Surgery - British Volume 1988;70(4):677.

References to studies awaiting assessment

NCT00800124 {published data only}
    1. NCT00800124.A prospective randomised multicenter study on cemented and non-cemented hemiprosthesis in older patients with dislocated hip fracture. clinicaltrials.gov/ct2/show/record/NCT00800124 (first received 27 November 2008).
NCT00859378 {published data only}
    1. NCT00859378.A prospective, randomized study comparing cemented and non-cemented semiendoprostheses in the treatment of proximal femoral fractures in the elderly patients. clinicaltrials.gov/ct2/show/study/NCT00859378 (first received 10 March 2008).
NCT01432691 {published data only}
    1. NCT01432691.Clinical and RSA comparison of hemi versus total hip arthroplasty after displaced femoral neck fracture. A randomized double-blind study. clinicaltrials.gov/ct2/show/study/NCT01432691 (first received 9 September 2011).
NTR1782 {published data only}
    1. NTR1782.Randomised clinical trial comparing cemented and hydroxy-apatite coated uncemented hemi-arthroplasty in the elderly patient with a proximal intracapsular femoral fracture. trialregister.nl/trial/1681 (first received 28 April 2009).

References to ongoing studies

ChiCTR1800019531 {published data only}
    1. ChiCTR1800019531.A randomized controlled trial for comparing the hemiarthroplasty with the total hip arthroplasty in the treatment of femoral neck fractures in patients older than 75 years. www.chictr.org.cn/showproj.aspx?proj=31624 (first received 16 November 2018).
ISRCTN15606075 {published data only}
    1. ISRCTN15606075.A randomised controlled trial of single antibiotic cement versus dual antibiotic cement in patients receiving a partial hip joint replacement after fracture. www.isrctn.com/ISRCTN15606075 (first received 16 July 2018).
NCT01109862 {published data only}
    1. NCT01109862.Prospective randomized comparison of bipolar hemiarthroplasty and total hip arthroplasty with large femoral heads for the treatment of displaced intracapsular femoral neck fractures in the elderly. clinicaltrials.gov/ct2/show/record/NCT01109862 (first received 22 April 2010).
NCT01578408 {published data only}
    1. NCT01578408.Corail-SP study - a prospective randomized comparison between cemented and uncemented hydroxyapatite coated prosthesis stems in total hip arthroplasty in patients with femoral neck fractures. clinicaltrials.gov/ct2/show/record/NCT01578408 (first received 11 April 2012).
NCT01787929 {published data only}
    1. NCT01787929.Cemented versus uncemented hemiarthroplasty for displaced femoral neck fracture in elderly patient: a randomised prospective trial. clinicaltrials.gov/ct2/show/record/NCT01787929 (first received 11 February 2013).
UMIN000011303 {published data only}
    1. UMIN000011303.A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in active patients. upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000013209 (first received 1 October 2013).
Wolf 2020 {published data only}
    1. NCT03909815.Do dual mobility cups prevent dislocation after total hip arthroplasty performed due to femoral neck fracture? A registry-based, pragmatic, randomized controlled trial comparing dual mobility with standard cups. clinicaltrials.gov/ct2/show/nct03909815 (first received 10 April 2019).
    1. Wolf O, Mukka S, Notini M, Moller M, Hailer NP.Study protocol: The DUALITY trial-a register-based, randomized controlled trial to investigate dual mobility cups in hip fracture patients. Acta Orthopaedica 2020;June:1-8. - PMC - PubMed

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References to other published versions of this review

Sreekanta 2019
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Publication types