Cemented Thompson versus Cemented Bipolar Prostheses for Femoral Neck Fractures

Bauer, Stefan; Isenegger, Patrick; Gautschi, Oliver; Ho, Kwok M.; Yates, Piers; Zellweger, René

doi:10.1177/230949901001800207

Cited by 9 publications

(14 citation statements)

References 22 publications

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“…This may be attributable to the use of cement 7 and recent studies have defended its use in selected patient groups. 80,81 In very elderly patients with limited mobility, it seems reasonable that subtle design differences between cemented modular and monoblock hemiarthroplasty prostheses may not be clinically detectable, providing the implants are inserted via a direct lateral approach. 63 The short remaining life-span of these patients precludes the development of long-term complications such as acetabular erosion.…”

Section: Methodsmentioning

confidence: 99%

Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients

Rogmark

Leonardsson²

2016

The Bone & Joint Journal

137

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Section: Methodsmentioning

confidence: 99%

Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients

Rogmark

Leonardsson²

2016

The Bone & Joint Journal

137

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“…After review, four papers including 21 017 patients were selected for inclusion. 2 , 7 - 9 ( Fig. 1 , Tables I and II ).…”

Section: Resultsmentioning

confidence: 97%

“…Overall, the methods were of medium or low quality. Two were retrospective cohorts 2 , 8 , one was a prospective randomised controlled trial 7 and one was a Swedish Joint Registry paper. 9 …”

Section: Resultsmentioning

confidence: 99%

“…Bauer et al 2 used a retrospective cohort to compare the Thompson stem with an Exeter stem with a bipolar head, rather than unipolar as specified. The paper was selected due to relevance to our study question.…”

Section: Resultsmentioning

confidence: 99%

“…The Thompson implant has been used for many decades and continues to enjoy popularity particularly for older, less active patients due to low cost and good results. 2 There is, however, variation in usage and a trend for decreasing use of monoblock stems including the Thompson. The number of such procedures reported in the Australian Joint Registry annual report was 12.6% lower in 2014 than in 2013 and is down 60.1% from 2003.…”

Section: Introductionmentioning

confidence: 99%

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Thompson hemiarthroplasty versus modular unipolar implants for patients requiring hemiarthroplasty of the hip

Sims

Farrier

Reed

et al. 2017

Bone & Joint Research

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ObjectivesThe objective of this study was to assess all evidence comparing the Thompson monoblock hemiarthroplasty with modular unipolar implants for patients requiring hemiarthroplasty of the hip with respect to mortality and complications.MethodsA literature search was performed to identify all relevant literature. The population consisted of patients undergoing hemiarthroplasty of the hip for fracture. The intervention was hemiarthroplasty of the hip with a comparison between Thompson and modular unipolar prostheses.Pubmed, Embase, CINAHL, Web of Science, PROSPERO and the Cochrane Central Register of Controlled Trials.The study designs included were randomised controlled trials (RCTs), well designed case control studies and retrospective or prospective cohort studies. Studies available in any language, published at any time until September 2015 were considered. Studies were included if they contained mortality or complications.ResultsThe initial literature search identified 4757 items for examination. Four papers were included in the final review. The pooled odds ratio for mortality was 1.3 (95% confidence Interval 0.78 to 2.46) favouring modular designs. The pooled odds ratio for post-operative complications was 1.1 (95% CI 0.79 to 1.55) favouring modular designs. Outcomes were reported at 12 or six months. These papers all contained potential sources of bias and significant clinical heterogeneity.ConclusionThe current evidence comparing monoblock versus modular implants in patients undergoing hemiarthroplasty is weak. Confidence intervals around the pooled odds ratios are broad and incorporate a value of one. Direct comparison of outcomes from these papers is fraught with difficulty and, as such, may well be misleading. A well designed randomised controlled trial would be helpful to inform evidence-based implant selection.Cite this article: A. L. Sims, A. J. Farrier, M. R. Reed, T. A. Sheldon. Thompson hemiarthroplasty versus modular unipolar implants for patients requiring hemiarthroplasty of the hip: A systematic review of the evidence. Bone Joint Res 2017;6:–513. DOI: 10.1302/2046-3758.68.BJR-2016-0256.R1.

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Total hip arthroplasty compared to bipolar and unipolar hemiarthroplasty for displaced hip fractures in the elderly: a Bayesian network meta-analysis

Migliorini

Maffulli

Trivellas

et al. 2022

Eur J Trauma Emerg Surg

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Purpose Displaced femoral neck fractures (FNF) usually require surgical treatment with either a total hip arthroplasty (THA), unipolar hemiarthroplasty (U-HHA), or bipolar hemiarthroplasty (B-HHA). However, there is still controversy regarding the optimal implant. This network meta-analysis compared the outcomes and complication rates of THA versus B-HHA and versus U-HHA in elderly patients with FNF. Material and methods This study was conducted according to the PRISMA extension statement for reporting of systematic reviews, and incorporated network meta-analyses of health care interventions. The literature search was performed in September 2020. All randomized clinical trials comparing two or more of the index surgical interventions for displaced FNF in the elderly were eligible for inclusion. For the Bayesian network meta-analysis, the standardized mean difference (SMD) and Log Odd Ratio (LOR) were used. Results Data from 24 RCTs (2808 procedures) were analysed. The mean follow-up was 33.8 months. The THA group had the longest surgical time (SMD 85.74) and the greatest Harris Hip Score (SMD − 17.31). THA scored similarly in terms of mortality (LOR 3.89), but had lower rates of revision surgeries (LOR 2.24), higher rates of dislocations (LOR 2.60), and lower rates of acetabular erosion (LOR − 0.02). Cementless implants required a shorter surgical duration (− 18.05 min; P = 0.03). Mortality was positively associated with acetabular erosion (P = 0.006), female gender (P = 0.007), revision (P < 0.0001). Conclusion THA led to the highest Harris Hip scores and lowest rate of revision surgery compared to B-HHA and U-HHA. However, B-HHA had the lowest dislocation rate when compared with U-HHA and THA. No significant differences in functional outcomes and complication rates were found between cemented and uncemented implants; however, a tendency for lower mortality, revision and dislocation rates in cemented implants was evidenced. Level of evidence I, Bayesian network meta-analysis of RCTs.

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Cemented Thompson versus Cemented Bipolar Prostheses for Femoral Neck Fractures

Cited by 9 publications

References 22 publications

Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients

Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients

Thompson hemiarthroplasty versus modular unipolar implants for patients requiring hemiarthroplasty of the hip

Total hip arthroplasty compared to bipolar and unipolar hemiarthroplasty for displaced hip fractures in the elderly: a Bayesian network meta-analysis

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