A systematic review 1 including 106 studies with a total of 6 333 subjects undergoing internal fixation, 13 090 undergoing hemiarthroplasty, and 746 undergoing total hip replacement, was abstracted in DARE. The rate of reoperation within two years ranged from 20 - 36% after internal fixation and from 6 - 18% after hemiarthroplasty (relative risk 2.6, 95% CI 1.4 to 4.6). Most common reasons for reoperation were non-union (33%) and avascular necrosis (16%). Patients reported less pain after arthroplasty than after internal fixation (15% vs 30%, p=0.05). There was no significant difference in mobility between treatment groups. There was no significant difference between internal fixation and arthroplasty with regard to the incidence of deep vein thrombosis and pulmonary embolism. There were more deep infections after arthroplasty than after internal fixation (p=0.001).
Comment: There are limitations in the quality of the data.
Primary/Secondary Keywords