Meta analysis of unipolar versus bipolar hemiarthroplasty for elderly patients with femoral neck fracture

Abstract

Objective To evaluate the effect of unipolar versus bipolar hemiarthroplasty for treatment of femoral neck fracture in the elderly Methods Related randomized controlled trials (RCTs) and quasi-randomized controlled trials (qRCTs) were searched from computerized databases MEDLINE,EMBASE,Cochrane Library,and CBM disc.Additional studies were identified through hand searches of 10 domestic journals.Time period of the search was from 1966 to June 2012.RevMan 4.2.8 software was used for data analysis.Results A total of 7 RCTs and 3 qRCTs were included.In this meta analysis,bipolar hemiarthroplasty was associated with better hip function compared with unipolar hemiarthroplasty at postoperative 6 months (RR =0.74,95％ CI0.62-0.88,P ＜ 0.01).However,the two procedures revealed no significant differences in terms of postoperative one-year dislocation rate (RR =1.01,95％ CI0.54-1.89,P ＞ 0.05),reoperation rate (RR =1.13,95％ CI 0.74-1.72,P ＞ 0.05),major complication incidence (except for dislocation) (RR =1.27,95％ CI 0.74-2.18,P ＞ 0.05),and postoperative 2-year mortality (RR1.16,95％ CI 0.73-1.87,P ＞ 0.05).Conclusion Bipolar hemiarthroplasty is preferable to unipolar hemiarthroplasty for hip function improvement,but postoperative one-year dislocation rate,reoperation rate,major complication incidence (except for dislocation),and postoperative twoyear mortality are similar for the two procedures. Key words: Femoral neck fractures ; Aged ; Arthroplasty, replacement, hip; Meta-analysis