title: Meta-analysis comparing total hip arthroplasty with hemiarthroplasty in the treatment of displaced femoral neck fractures in patients over 70 years old.
abstract: OBJECTIVE
  Total hip arthroplasty (THA) and hemiarthroplasty (HA) are effective methods currently used to treat femoral neck fracture in elderly patients, but the two options remain controversial in patients over 70 years old. The main purpose of our study was to determine whether THA or HA is a superior treatment of femoral fractures involving a displaced neck in patients who are over 70 years of age.
  
  
  METHODS
  A computer-based online search of Medline (1970-2011), PubMed (1977-2011), and the Cochrane Central Register of Controlled Trials (2002-2011) was conducted. Six relevant randomized controlled trials with a total of 739 patients were included for the final analysis. The analysis was performed with software RevMan 5.0.
  
  
  RESULTS
  We found that compared with THA, HA needed shorter average time and lost less blood. While over the long-term follow-up, THA patients exhibited significantly less pain and better function and were less likely to require a revision hip surgery. Postoperative infection was equally common among HA and THA patients.
  
  
  CONCLUSIONS
  The significant differences in outcomes suggest that THA is a valuable treatment option for active elderly hip fracture individuals. However, patients who are older, impaired or institutionalized benefit from HA.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Jun-Hui
authors.initials: JH
authors.lastname: He
authors.forename: Cheng-Pei
authors.initials: CP
authors.lastname: Zhou
authors.forename: Zong-Ke
authors.initials: ZK
authors.lastname: Zhou
authors.forename: Bin
authors.initials: B
authors.lastname: Shen
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.forename: Peng-de
authors.initials: PD
authors.lastname: Kang
authors.forename: Fu-Xing
authors.initials: FX
authors.lastname: Pei
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D005265:Femoral Neck Fractures / Q000601:surgery; D062785:Hemiarthroplasty; D006801:Humans; D011183:Postoperative Complications; D012086:Reoperation