Cochrane · systematic review · CD013410
Arthroplasties for hip fracture in adults
Lewis, SR, Macey, R, Parker, MJ, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
21
No studies
3
Included studies
NR
No studies 3 · 12.5%Ungraded 0 · 0%Very low 8 · 33.3%Low 8 · 33.3%Moderate 5 · 20.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cemented versus uncemented hemiarthroplasty for hip fracture in adults
Population: adults with displaced and undisplaced hip fractures; included studies were for intracapsular fractures, except for one study of extracapsular fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities in daily living, early (within 4 months): using GARS (range from 18 to 72), a social dependency scale (range of scores 1 to 9); lower values in these scales indicate more independence. Also using OARS‐IADL (range from 0 to 14) and a 5‐p... Cemented vs uncemented hemiarthroplasty | no estimate extracted | 4 studies · 1275 participants | Moderate Downgraded: risk of bias |
Delirium (end of Cemented vs uncemented hemiarthroplasty | RR 1.06 [0.55, 2.06] | 2 studies · 800 participants | Low Downgraded: risk of bias, imprecision |
Functional status, early (within 4 months): using HHS (range from 0 to 100); higher values indicate better function Cemented vs uncemented hemiarthroplasty | no estimate extracted | 3 studies · 416 participants | Very low Downgraded: risk of bias, imprecision |
HRQoL, early (within 4 months): using EQ‐5D (range 0 to 1), and SF‐12 (range 0 to 100); higher values indicate better quality of life. Cemented vs uncemented hemiarthroplasty | no estimate extracted | 3 studies · 1122 participants | Moderate Downgraded: risk of bias |
Mobility, early (within 4 months): able to walk outdoors using no more than 1 walking aid. Cemented vs uncemented hemiarthroplasty | RR 1.04 [0.95, 1.14] | 3 studies · 980 participants | Moderate Downgraded: risk of bias |
Mortality, early (within 4 months) Cemented vs uncemented hemiarthroplasty | RR 95 [0.8, 1.13] | 12 studies · 3136 participants | Low Downgraded: risk of bias, imprecision |
Mortality at 12 months Cemented vs uncemented hemiarthroplasty | RR 0.86 [0.78, 0.96] | 15 studies · 3727 participants | Moderate Downgraded: risk of bias |
Unplanned return to theatre (end of Cemented vs uncemented hemiarthroplasty | RR 0.7 [0.45, 1.1] | 6 studies · 2336 participants | Low Downgraded: risk of bias |
Bipolar hemiarthroplasty compared with unipolar hemiarthroplasty for hip fracture in adults
Population: adults with displaced and undisplaced hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living, early (within 4 months) Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | no estimate extracted | NR | No studies |
Early delirium Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | RR 0.48 [0.09, 2.58] | 1 study · 261 participants | Very low Downgraded: risk of bias, imprecision |
Functional status, early (within 4 months) Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | no estimate extracted | NR | No studies |
HRQoL, early (within 4 months): using EQ‐5D (range 0 to 1); higher values indicate better quality of life Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | no estimate extracted | 1 study · 115 participants | Very low Downgraded: risk of bias, imprecision |
Mobility, early (within 4 months) Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | no estimate extracted | NR | No studies |
Mortality, early (within 4 months) Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | RR 0.94 [0.54, 1.64] | 4 studies · 573 participants | Low Downgraded: risk of bias, imprecision |
Mortality at 12 months Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | RR 1.17 [0.89, 1.53] | 8 studies · 839 participants | Low Downgraded: risk of bias, imprecision |
Unplanned return to theatre (end of Bipolar hemiarthroplasty vs unipolar hemiarthroplasty | RR 1.08 [0.44, 2.64] | 4 studies · 532 participants | Very low Downgraded: risk of bias, imprecision |
Total hip arthroplasty compared with hemiarthroplasty for hip fracture in adults
Population: adults with displaced and undisplaced hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living, early (within 4 months): using Katz Index and an undefined measurement tool to identify people who were independent Total hip arthroplasty vs hemiarthroplasty | RR 1.03 [0.91, 1.18] | 2 studies · 225 participants | Very low Downgraded: risk of bias, imprecision |
Delirium (end of Total hip arthroplasty vs hemiarthroplasty | RR 1.41 [0.6, 3.33] | 2 studies · 357 participants | Low Downgraded: risk of bias, imprecision |
Functional status, early (within 4 months): using HHS (range from 0 to 100) and Johansen hip score (range from 0 to 100); higher scores indicate better function Total hip arthroplasty vs hemiarthroplasty | no estimate extracted | 3 studies · 395 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
HRQoL, early (within 4 months): using EQ‐5D (range from 0 to 1); higher scores indicate better quality of life Total hip arthroplasty vs hemiarthroplasty | no estimate extracted | 2 studies · 279 participants | Very low Downgraded: risk of bias, imprecision |
Mobility, early (within 4 months): using a 9‐point mobility scale; lower scores indicate better mobility Total hip arthroplasty vs hemiarthroplasty | no estimate extracted | 1 study · 83 participants | Low Downgraded: risk of bias, imprecision |
Mortality, early (within 4 months) Total hip arthroplasty vs hemiarthroplasty | RR 0.77 [0.42, 1.42] | 6 studies · 725 participants | Very low Downgraded: risk of bias, imprecision |
Mortality at 12 months Total hip arthroplasty vs hemiarthroplasty | RR 1 [0.82, 1.34] | 11 studies · 2667 participants | Moderate Downgraded: risk of bias |
Unplanned return to theatre (end of Total hip arthroplasty vs hemiarthroplasty | RR 0.68 [0.41, 1.15] | 9 studies · 2476 participants | Low Downgraded: risk of bias, imprecision |