• David González-Martín, Luis Enrique Hernández-Castillejo, Mario Herrera-Pérez, José Luis Pais-Brito, Sergio González-Casamayor, and Miriam Garrido-Miguel.
• Orthopedic Surgery and Traumatology Service, Hospital Universitario de Canarias, Tenerife, Spain.
• Eur J Trauma Emerg Surg. 2023 Feb 1; 49 (1): 8710687-106.

PurposeSeveral studies comparing osteosynthesis and stem revision in Vancouver B2 (VB2) periprosthetic hip fractures (PPHF) have been published. This work aims to be the first systematic review and meta-analysis to include only studies involving statistical comparison between the two techniques.MethodsMEDLINE, EMBASE, Cochrane Library, and Web of Science databases were systematically searched from inception to October 2021 for studies involving a comparison between VB2 treated by osteosynthesis versus revision arthroplasty. The effect size (ES) was calculated using Cohen´s d index.ResultsFrom 17 published studies selected, a total of 856 patients were recruited (363 osteosynthesis / 493 revision arthroplasty). The pooled ES estimates for the Parker mobility score were 1.03 (95% CI, 0.22-1.84; I2 = 87.7%) for ORIF surgery, and 0.54 (95% CI, - 0.10-1.17; I2 = 83%) for revision surgery. The pooled ES estimates for the operative time, reintervention, complications, hospital stay and needing for blood transfusion were significant lower in ORIF than in revision surgery. There were no differences in first-year mortality between groups. There was a higher proportion of ASA > 3 patients in the ORIF group.ConclusionOsteosynthesis versus revision arthroplasty has a shorter operative time, less need for blood transfusion, fewer complications and reoperation rate and shorter hospital stay. Nonetheless, similar results were found for functional tests and first-year mortality. These results support the use of osteosynthesis in selected patients (low functional demand, multiple comorbidities, and high anesthetic risk).Level Of EvidenceIII.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

24 keywords...

hide…