Long-term Mortality After Revision THA.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. 2. J Arthroplasty. 2019 Aug;34(8):1837-1843.e2. doi: 10.1016/j.arth.2019.03.070. Epub 2019 Apr 6. Hemiarthroplasty vs Total Hip Arthroplasty for the Management of Displaced Neck of Femur Fractures: A Systematic Review and Meta-Analysis. Lewis DP(1), Wæver D(2), Thorninger R(2), Donnelly WJ(3). Author information: (1)School of Rural Medicine, University of New England, Armidale, Australia. (2)Department of Orthopaedics, Regionshospitalet Randers, Randers, Denmark. (3)Brisbane Orthopaedic Specialist Services, Brisbane, Australia. Erratum in J Arthroplasty. 2019 Dec;34(12):3137-3141. doi: 10.1016/j.arth.2019.08.061. BACKGROUND: Displaced femoral neck fractures (DFNF) are common and can be treated with osteosynthesis, hemiarthroplasty (HA), or total hip arthroplasty (THA). There is no consensus as to which intervention is superior in managing DFNF. METHODS: Studies were identified through a systematic search of the MEDLINE database, EMBASE database, and Cochrane Controlled Trials. Included studies were randomized or controlled trials (1966 to August 2018) comparing THA with HA for the management of DFNF. (https://www.crd.york.ac.uk/PROSPERO Identifier: CRD42018110057). RESULTS: Seventeen studies were included totaling 1364 patients (660 THA and 704 HA). THA was found to be superior to HA in terms of risk of reoperation, Harris Hip Score and Quality of Life (Short Form 36). Overall, the risk of dislocation was greater in THA group than HA in the first 4 years, after which there was no difference. There was no difference between THA and HA in terms of mortality or infection. CONCLUSION: Overall, THA appears to be superior to HA. THA should be the recommended intervention for DFNF in patients with a life expectancy >4 years and in patients younger than 80 years. However, both HA and THA are reasonable interventions in patients older than 80 years and with shorter life expectancy. Copyright © 2019. Published by Elsevier Inc. DOI: 10.1016/j.arth.2019.03.070