Risk Factors with Multilevel Evidence for Dislocation in Patients with Femoral Neck Fractures After Hip Hemiarthroplasty: A Systematic Review.

Wang, B; Liu, H; Zhu, Y; Yan, L; Li, JJ; Zhao, B

Risk Factors with Multilevel Evidence for Dislocation in Patients with Femoral Neck Fractures After Hip Hemiarthroplasty: A Systematic Review.

Wang, B Liu, H Zhu, Y Yan, L Li, JJ Zhao, B

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Publisher:: SPRINGER HEIDELBERG
Publication Type:: Journal Article
Citation:: Indian journal of orthopaedics, 2020, 54, (6), pp. 795-804
Issue Date:: 2020-11

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Field	Value	Language
dc.contributor.author	Wang, B
dc.contributor.author	Liu, H
dc.contributor.author	Zhu, Y
dc.contributor.author	Yan, L
dc.contributor.author	Li, JJ
dc.contributor.author	Zhao, B
dc.date.accessioned	2021-03-18T03:58:15Z
dc.date.available	2020-06-15
dc.date.available	2021-03-18T03:58:15Z
dc.date.issued	2020-11
dc.identifier.citation	Indian journal of orthopaedics, 2020, 54, (6), pp. 795-804
dc.identifier.issn	0019-5413
dc.identifier.issn	1998-3727
dc.identifier.uri	http://hdl.handle.net/10453/147324
dc.description.abstract	<h4>Background</h4>Hip hemiarthroplasty (HA) is a standard surgical procedure for elderly patients with displaced fracture of the femoral neck, where dislocation is a possible complication. This study is a systematic review on the risk factors of implant dislocation in patients with femoral neck fracture following hip hemiarthroplasty (HA), and evaluates the methodological quality of the included studies.<h4>Methods</h4>Studies on risk factor assessment of dislocation following hip HA were sourced from EMBASE, Ovid, PubMed and ScienceDirect databases. The quality of included studies was evaluated using an improved quality evaluation method combined with a best-evidence synthesis method.<h4>Results</h4>A total of 130,127 patients were involved in 17 observational studies included in this systematic review, with a dislocation rate that ranged between 0.76 and 12.2% (overall incidence was 4-5% by meta-analysis). According to the applied quality evaluation criteria, eight studies were considered to be of high quality, six to be of medium quality, and three to be of low quality. The posterolateral surgical approach was identified as the only risk factor supported by strong evidence, while patients with small acetabular coverage and low postoperative offset were identified as risk factors supported by moderate evidence, and 11 other risk factors were supported by limited evidence.<h4>Conclusion</h4>This systematic review provides some evidence in helping surgeons develop optimal prevention strategies for dislocation following hip HA during the perioperative period based on common risk factors identified in the literature. However, conclusive evidence supporting most of these risk factors is lacking and more methodologically rigorous studies are required to increase the confidence of recommendations.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	SPRINGER HEIDELBERG
dc.relation.ispartof	Indian journal of orthopaedics
dc.relation.isbasedon	10.1007/s43465-020-00177-5
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.title	Risk Factors with Multilevel Evidence for Dislocation in Patients with Femoral Neck Fractures After Hip Hemiarthroplasty: A Systematic Review.
dc.type	Journal Article
utslib.citation.volume	54
utslib.location.activity	Switzerland
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2021-03-18T03:58:10Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	54
utslib.citation.issue	6

Abstract:

Background

Hip hemiarthroplasty (HA) is a standard surgical procedure for elderly patients with displaced fracture of the femoral neck, where dislocation is a possible complication. This study is a systematic review on the risk factors of implant dislocation in patients with femoral neck fracture following hip hemiarthroplasty (HA), and evaluates the methodological quality of the included studies.

Methods

Studies on risk factor assessment of dislocation following hip HA were sourced from EMBASE, Ovid, PubMed and ScienceDirect databases. The quality of included studies was evaluated using an improved quality evaluation method combined with a best-evidence synthesis method.

Results

A total of 130,127 patients were involved in 17 observational studies included in this systematic review, with a dislocation rate that ranged between 0.76 and 12.2% (overall incidence was 4-5% by meta-analysis). According to the applied quality evaluation criteria, eight studies were considered to be of high quality, six to be of medium quality, and three to be of low quality. The posterolateral surgical approach was identified as the only risk factor supported by strong evidence, while patients with small acetabular coverage and low postoperative offset were identified as risk factors supported by moderate evidence, and 11 other risk factors were supported by limited evidence.

Conclusion

This systematic review provides some evidence in helping surgeons develop optimal prevention strategies for dislocation following hip HA during the perioperative period based on common risk factors identified in the literature. However, conclusive evidence supporting most of these risk factors is lacking and more methodologically rigorous studies are required to increase the confidence of recommendations.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/147324