scholarly journals Letter to the Editor regarding “Hemiarthroplasty compared to total hip arthroplasty for the treatment of femoral neck fractures: a systematic review and meta-analysis”

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qiujiang Li ◽  
Xingxia Long ◽  
Yinbin Wang ◽  
Xiaocheng Jiang ◽  
Lijun Cai
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Femoral Neck Fractures ◽  
Total Hip ◽  
Letter To The Editor

Outcomes of total hip arthroplasty using dualmobility cups for femoral neck fractures: a systematic review and meta-analysis

2020 ◽  
pp. 112070002092665
Author(s):  
Syed H Mufarrih ◽  
Nada Q Qureshi ◽  
Bassam Masri ◽  
Shahryar Noordin
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Femoral Neck Fractures ◽  
Cochrane Library ◽  
Total Hip ◽  
The Mean

Objectives: Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. Methods: 2 authors independently searched PubMed (MEDLINE), Google Scholar and Cochrane library for studies reporting dislocation and mortality rates for FNFs treated with DMC-THA since inception up to January 2019. Data on outcomes of interest was extracted from all studies and assessed for eligibility for a meta-analysis. Results: Out of 522 search results, 18 studies were included in the systematic review and 4 in the meta-analysis. The mean rate of dislocation following DMC-THA for FNFs was found to be 1.87% ± 2.11, with a 1-year mortality rate of 14.0% ± 10.55. Results of meta-analysis showed that dislocation and 1-year postoperative mortality rates were significantly lower for DMC-THA with a risk ratio 0.31 (95% CI, 0.16–0.59; I2 = 0%, p  = 0.0003) and 0.55 (0.40, 0.77; I2 = 0%, p = 0.003) respectively when compared to biploar hemiathroplasty (BHA). Conclusions: The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.

Efficacy of NSAIDs versus radiotherapy for heterotopic ossification prophylaxis following total hip arthroplasty in high-risk patients: a systematic review and meta-analysis

2021 ◽  
pp. 112070002199111
Author(s):  
Jacob Shapira ◽  
Mitchell J Yelton ◽  
Jeffery W Chen ◽  
Philip J Rosinsky ◽  
David R Maldonado ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Comparable Efficacy ◽  
Total Hip ◽  
High Risk Patients ◽  
Randomised Control Trials ◽  
Risk Patients

Background: The aims of this systematic review were: (1) to investigate the prophylactic effect of radiotherapy (RT) and NSAIDs in high-risk patients following total hip arthroplasty (THA); and (2) to compare the efficacy of non-selective and COX-II selective NSAIDs in preventing post-THA HO, utilising a meta-analysis of randomised control studies. Methods: The PubMed, Embase, and Cochrane Databases were searched for articles regarding HO following THA in March 2019. Studies were included if they contained data regarding HO incidence after THA or contained data regarding HO prophylaxis comparison of NSAIDs and/or RT in terms of dosage or duration. Results: 24 studies reported on populations that were not at high-risk for HO. These studies reported between 47.3% and 90.4% of their patient populations had no HO formation; between 2.8% and 52.7% had mild formation; and between 0.0% and 10.4% had severe formation. A total of 13 studies reported on populations at high-risk for HO. Studies analysing RT in high-risk patients reported between 28.6% and 97.4% of patients developed no HO formation; between 1.9% and 66.7% developed mild HO formation; and between 0.0% and 11.9% developed severe HO formation. Studies analysing NSAID treatment among high-risk populations reported between 76.6% and 88.9% had no HO formation; between 11.1% and 23.4% had mild HO formation, and between 0.0% and 1.8% had severe HO formation. 9 studies were identified as randomised control trials and subsequently used for meta-analysis. The relative risk for COX-II in developing any HO after THA was not significantly different compared to non-selective NSAIDs (RR 1.00; CI, 0.801–1.256; p = 0.489). Conclusions: NSAIDs prophylaxis for HO may have better efficacy than RT in high-risk patients following THA. Non-selective and COX-II selective NSAIDs have comparable efficacy in preventing HO. Factors such as medical comorbidities and side-effect profile should dictate the prophylaxis recommendation.

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