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《Journal of Clinical Rehabilitative Tissue Engineering Research》 2010-35
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Total hip replacement versus femoral head replacement in treatment of elderly femoral neck fracture: Meta analysis of efficacy and safety

Chen Guang-dong1, Wang Zhen-bin2, Chen Jian-chang3, Lu Lan-hong4, Li Xiu-qing5, Wang Hui-cai61Xinjiang Medical University, Urumchi 830011, Xinjiang Uygur Autonomous Region, China; 2First Department of Spinal Surgery, Fourth Affiliated Hospital of Xinjiang Medical University, Urumchi 830000, Xinjiang Uygur Autonomous Region, China; 3Orthopedics Center of Urumchi General Hospital, Lanzhou Military Area Command of Chinese PLA, Urumchi 830000, Xinjiang Uygur Autonomous Region, China; 4Cangzhou Medical College, Cangzhou 061001, Hebei Province, China; 5Cangzhou People’s Hospital, Cangzhou 061001, Hebei Province, China; 6Teaching and Research Section of Evidence-based Medicine, First Hospital of Xinjiang Medical University, Urumchi 830011, Xinjiang Uygur Autonomous Region, China  
OBJECTIVE: To compare the clinical outcomes and safety between total hip replacement and femoral head replacement in treatment of elderly patients with femoral neck fracture based on Meat analysis of large samples. METHODS: A computer-based online search of CBM (2010-04), CNKI (2010-04) and VIP (2010-04) was performed for clinical randomized trials regarding total hip replacement and femoral head replacement in treatment of elderly patients with femoral neck fracture. Meta analysis was used to analyze prosthesis function, operation time, bleeding, complication and hip pain. RESULTS: A total of 7 clinical control studies were included, involving 624 patients aged 60 years, including 329 patients undergoing total hip replacement (experimental group) and 295 undergoing femoral head replacement (control group). Meta analysis showed that the efficacy of total hip replacement was better than femoral head replacement [OR=2.88, 95% confidence interval (1.84, 4.49), P 0.05]. The operation time of experimental group was longer than control group [WMD=43.35, 95% confidence interval (23.96, 62.74), P 0.05]. The bleeding volume of experimental group was greater than control group [WMD=336.36, 95% confidence interval (196.34, 476.37), P 0.05]. There were no significant differences in complications between two groups [OR=0.54, 95% confidence interval (0.29, 1.02), P 0.05]. The hip joint pain of experimental group was less than control group [OR=0.30, 95% confidence interval (0.18, 0.50), P 0.05]. CONCLUSION: Total hip replacement exhibited better long-term clinical outcomes compared with femoral head replacement in treatment of elderly femoral head fracture, in particular for primary hip disease and for patients with strong activity. However, the operation time and bleeding volume were greater than femoral head replacement. Large sample, randomized, controlled studies are required for further validation.
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【CateGory Index】: R687.3
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