Meta-analysis Of Hemi-arthroplasty versus Total arthroplasty for treatment of fracture neck femur in Patients over 60 Years of Age / by Ayman Mohamed Abo agaga madi ; Under supervision of Prof.Dr. Ashraf Abdelkader Elnahal, Lecturer Dr. Elsayed Mohamed Kassem, Dr. Abdelhamid Mohamed Elshabrawy.

Thesis (M.Sc.)-Cairo University, 2023.

Bibliography: pages 79-87.

Fractures of the femoral neck, which are usually
fragility fractures following a low-energy injury, have a risk that increases
with age, especially for those with over 60 years old. Hemi-arthroplasty
(HA) and total hip arthroplasty (THA) have been shown to be an effective
treatment for femoral neck fractures. The use of large head size in THA and
(DM-THA) can decrease the rate of dislocation in both primary and
revision; also decreases wear of acetabular cartilage with HA.
Aim of study: To evaluate the evidence from studies that assesses the
functional outcome of hemi-arthroplasty (HA) and total hip arthroplasty
(THA) for treatment of femoral neck fractures in patients more than 60
years.
Method: We conducted this systematic review and meta-analysis
according to the Cochrane handbook of systematic reviews of intervention.
We searched PubMed, Scopus, Cochrane, Web of Science, Embase, and
Science Direct till June 2022 with relevant keywords. Studies designs
included randomized controlled trials (RCTs) or non RCTs including
Cohort, Case controls, and case series, comparative studies between
Functional outcomes including Harris hip score (HHS), and Complications
rate of total hip versus hemi-arthroplasty for treatment of femoral neck
fractures, patients with femoral neck fractures undergoing the surgical
procedure of total hip replacement, and elderly patients age over 60 years
old.
Results: The analysis of the study found higher dislocation rate of
THA than HA for treating femoral neck fractures. Using large head THA
and Dual mobility THA can reduce dislocation rate Also, the analysis
showed no significant differences between studies groups regarding post-
operative infection, reoperation rate, Harris hip score and no significant
risk of one year mortality rate
Abstract
3
Conclusion: In elderly patients over 60 years old with femoral neck
fracture, the choice of treatment depends on activity level. In active patient,
THA with large prosthetic head or dual mobility hip replacement is the
treatment of choice.
While in inactive patients, bipolar hemi-arthroplasty and total hip
arthroplasty with large prosthetic head are both options of treatment. This
is because of that hemi-arthroplasty and total hip arthroplasty both had
comparable results in terms of preventing potential complications and
enhancing functional outcomes.

الطرق و الوسائل التي اتبعت في جمع الرسائل وفرزها وعرضها :
وقد اشتمل ستة عشر بحثا جميعهم ينطبق عليهم المواصفات اللازمه للقبول في بحثنا بعد الماجعه من اثنين باحثين مختلفين وحسب القواعد الارشاديه الموصى بها عالميا في اجاء مثل هذه الأبحاث وفقًا لإرشادات بيان PRISMA التي ذكرها (Moher et al.، 2009)،البيانات التي كنا نبحث عنها هم خمسة نتائج هم معدل خلع المفصل بعد الجراحه , الحاله الوظيفيه للمريض بعد الجراحه , معدل احتماليه اعاده اجراء الجراحه , معدل العدوى المحتمله بعد الجراحه , معدل وفاة المريض بعد اول سنه من اجراء الجراحه . وقد تبين ايضا عدم وجود اختلاف واضح بين استعمال نصف المفصل الصناعي ثنائي القطب ومفصل الفخذ الصناعي الكامل من حيث اعاده اجراء الجراحه او حدوث عدوى فيما بعد الجراحه او نسبه الوفاة بعد اول سنه من اجراء الجراحه

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Text in English and abstract in Arabic & English.