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Bipolar versus unipolar hemiarthroplasty for displaced femoral neck fractures in the elder patient: a systematic review and meta-analysis of randomized trials

European Journal of Orthopaedic Surgery & Traumatology volume 25, pages 425–433 (2015)Cite this article

Abstract

Objective

To assess the safety and efficacy that compare bipolar hemiarthroplasty with unipolar hemiarthroplasty for the treatment of femoral neck fracture in the patient aged more than 65 years.

Methods

We searched databases including PubMed Central, MEDLINE (from 1966), EMBASE (from 1980) and the Cochrane Central Register of Controlled Trials database. Only prospective randomized controlled trials (RCTs) that compare bipolar hemiarthroplasty with unipolar hemiarthroplasty for the treatment of femoral neck fracture in the elder patient were included. RevMan 5.2 from the Cochrane Collaboration was applied to perform the meta-analysis.

Results

Six relevant RCTs with a total of 982 patients were retrieved. From this meta-analysis, mortality rates showed no statistical difference between two treatments, 14.7 % for bipolar versus 13.8 % for unipolar. The acetabular erosion rates were significantly different between two groups (P = 0.01), 1.2 % in bipolar versus 5.5 % in unipolar group. Overall complication rates, dislocation rates, infection rates and reoperation rates between two groups showed no statistical difference (P > 0.05). Neither of two treatments appeared to be superior regarding the clinical function assessed by Harris hip scores or return to pre-injury state rates (P > 0.05).

Conclusions

Both bipolar and unipolar hemiarthroplasty for the treatment of elderly patient suffering displaced femoral neck fracture achieve similar and satisfy clinical outcome in short-term follow-up. Unipolar hemiarthroplasty seems to be a more cost-effectiveness option for elderly patient.

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Conflict of interest

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Author information

Affiliations

  1. Department of Orthopedics and Traumatology, Yu Lin Orthopedics Hospital, YuLin, GuangXi, People’s Republic of China

    Bing Yang

  2. Department of Orthopedics, FuJian Provincial Hospital, Dong Jie Road No.134, FuZhou, 350001, FuJian, People’s Republic of China

    Xi Lin & Xiao Ming Yin

  3. State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China

    Xi Zhi Wen

Authors
  1. Bing Yang
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  2. Xi Lin
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  3. Xiao Ming Yin
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  4. Xi Zhi Wen
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Corresponding authors

Correspondence to Xiao Ming Yin or Xi Zhi Wen.

Additional information

Bing Yang and Xi Lin have contributed equally to this paper, both are first author.

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Yang, B., Lin, X., Yin, X.M. et al. Bipolar versus unipolar hemiarthroplasty for displaced femoral neck fractures in the elder patient: a systematic review and meta-analysis of randomized trials. Eur J Orthop Surg Traumatol 25, 425–433 (2015). https://doi.org/10.1007/s00590-014-1565-2

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  • DOI: https://doi.org/10.1007/s00590-014-1565-2

Keywords

  • Hemiarthroplasty
  • Femoral neck fractures
  • Unipolar
  • Bipolar