Falotico Guilherme Guadagnini, Matsunaga Fabio Teruo, Filho Jorge Sayum, Moraes Vinicius Ynoe, Garcia Marina Seike, Faloppa Flavio, Tamaoki Marcel Jun Sugawara, Belloti João Carlos
Orthopaedics Department -Escola Paulista de Medicina, Federal University Of Brazil, São Paulo, Brazil.
Escola Paulista de Medicina, Federal University Of Brazil, São Paulo, Brazil.
J Orthop Surg Res. 2025 Jul 29;20(1):718. doi: 10.1186/s13018-025-06144-w.
hip arthroplasties for the treatment of displaced femoral neck fractures in adults can be total replacement or hemiarthroplasty. Despite the large number of studies on the topic, the best choice of arthroplasty to be used remains unclear.
overview the results of systematic reviews of randomized controlled trials (RCTs) comparing outcomes between total hip replacement and hemiarthroplasty for displaced femoral neck fractures in adults.
The study followed the standards of the Prisma checklist and the Cochrane handbook.
Four electronic databases (Pubmed, Embase, Cochrane Library and Web of Science) were researched until January 2025. The primary outcomes were mortality, function, quality of life and revision rate and the secondary ones: dislocation, periprosthetic fracture, infection, and surgical time. Comparisons of dichotomous data were reported as the OR and 95% CI, and comparisons of functional and health related quality of life outcomes were reported as the mean difference and 95% CI.
twenty systematic reviews with a total of 29,980 patients were analyzed. Patients with total hip arthroplasty had a lower revision rate (RR 0.67, 95% CI 0.48 to 0.93; participants = 4078; studies = 22; I2 = 30%), better early function (SMD 0.59, 95% CI 0.04 to 1.08; participants = 963; studies = 12; I2 = 87%) and better quality of life (DM 0.05, 95% CI 0.03 to 0.08; participants = 1240; studies = 6; I2 = 28%). There was no difference regarding dislocation, infection, periprosthetic fracture and mortality. Surgical time was shorter in hemiarthroplasty (DM 20.46, 95% CI 12.12 to 28, 80; participants = 1493; studies = 16; I2 = 95%).
Total hip arthroplasty had a lower revision rate, better quality of life and function. The surgical time was on average 20 min shorter in hemiarthroplasty. Mortality, dislocation, infection, and periprosthetic fracture rates were similar.
(CRD42021237885), and published in August 2021 ( https://bmjopen.bmj.com/content/11/11/e051840.long ).
用于治疗成人移位型股骨颈骨折的髋关节置换术可以是全髋关节置换或半髋关节置换。尽管关于该主题的研究众多，但最佳的置换术选择仍不明确。
综述比较成人移位型股骨颈骨折全髋关节置换和半髋关节置换结局的随机对照试验（RCT）的系统评价结果。
本研究遵循Prisma清单和Cochrane手册的标准。
检索四个电子数据库（PubMed、Embase、Cochrane图书馆和Web of Science）直至2025年1月。主要结局为死亡率、功能、生活质量和翻修率，次要结局为：脱位、假体周围骨折、感染和手术时间。二分数据的比较报告为OR和95%CI，功能和健康相关生活质量结局的比较报告为平均差和95%CI。
分析了20项系统评价，共纳入29980例患者。接受全髋关节置换术的患者翻修率较低（RR 0.67，95%CI 0.48至0.93；参与者 = 4078；研究 = 22；I² = 30%），早期功能更好（SMD 0.59，95%CI 0.04至1.08；参与者 = 963；研究 = 12；I² = 87%），生活质量更好（DM 0.05，95%CI 0.03至0.08；参与者 = 1240；研究 = 6；I² = 28%）。在脱位、感染、假体周围骨折和死亡率方面无差异。半髋关节置换术的手术时间较短（DM 20.46，95%CI 12.12至28.80；参与者 = 1493；研究 = 16；I² = 95%）。
全髋关节置换术的翻修率较低，生活质量和功能更好。半髋关节置换术的手术时间平均短20分钟。死亡率、脱位、感染和假体周围骨折率相似。
（CRD42021237885），于2021年8月发表（https://bmjopen.bmj.com/content/11/11/e051840.long）
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