scholarly journals Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fracture: a protocol for an overview of systematic reviews

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051840
Author(s):  
Guilherme Guadagnini Falotico ◽  
Vinicius Ynoe Moraes ◽  
Fabio Teruo Matsunaga ◽  
Marcel Jun Sugawara Tamaoki ◽  
Flavio Faloppa ◽  
...  

IntroductionHip arthroplasties for the treatment of displaced femoral neck fractures in adults can be total replacement or hemiarthroplasty. Despite the high prevalence of these fractures and large number of studies on the topic, the best choice of arthroplasty to be used remains unclear. The present study aims to overview the results of systematic reviews of randomised controlled trials (RCTs) comparing outcomes between total hip replacement and hemiarthroplasty for displaced femoral neck fractures in adults.Methods and analysisFour electronic databases (Pubmed, Embase, Cochrane Library and Web of Science) and reference lists from previous reviews will be searched without language limitation. Eligible studies will be systematic reviews of RCT that compare total hip replacement and hemiarthroplasty for treatment of displaced femoral neck fractures in adults. Two reviewers will independently perform study selection, data extraction and quality assessment. Disagreements between reviewers will be resolved by a third reviewer. Comparisons of dichotomous data will report as the OR and 95% CI, and comparisons of functional and health-related quality of life outcomes are reported as the mean difference and 95% CI and as the risk difference, defined as the difference in the proportion achieving the minimum clinically important difference and 95% CI. As this overview will contribute to orthopaedic surgeons and health managers in better decision-making for the treatment of these fractures. The authors plan to complete the searches and analyses by 30 November 2021.Ethics and disseminationEthical approval was obtained at Federal University of Sao Paulo. Findings will be disseminated through peer-reviewed publication.PROSPERO registration numberCRD42021237885.

2020 ◽  
pp. 112070002091041 ◽  
Author(s):  
Ramy A M Rashed ◽  
Hannah Sevenoaks ◽  
Qaisar A Choudry ◽  
Mohammed S Kasem ◽  
Tarek A Elkhadrawe ◽  
...  

Introduction: Current guidelines recommend treating displaced femoral neck fractures with a total hip replacement in fit and active elderly patients. Dislocation remains the main complication. Dual-mobility cup (DMC) hip replacements maybe a solution to decrease dislocation, with the benefit of increasing stability, achieving better range of motion and functional outcomes. Patients and methods: This is a prospective randomised controlled trial which included 62 patients with Garden III and IV femoral neck fractures. The mean age was 67.2 years. 30 males and 32 females were included, randomised and allocated to 2 treatment groups; a cemented DMC replacement group, or a cemented 32-mm head total hip replacement (THR). The posterior approach was used in all patients. Postoperative functional outcome was assessed using Harris Hip Score (HHS). Health-related quality of life (HRQoL) was assessed using the SF-36 questionnaire. Results: The mean HHS for the DMC group at 4, 6 and 12 months were higher than mean HHS scores for the THR group ( p < 0.001). The range of motion at 1 year was statistically better in the DMC group compared to the THR group ( p < 0.001). The DMC showed a statistically better effect on the HRQoL measurements as compared to the THR group. There were no dislocations in both groups. Conclusions: DMC hip replacements provide better functional, patient reported outcomes, and range of motion than the conventional THR. Combined with its stability, DMC replacements are a useful solution in managing femoral neck fractures in active elderly patients. Trial serial number 020841 (IRB Number 00007555).


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