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OBJECTIVE: In hemiarthroplasty, the choice of prosthesis is particularly important, which directly affects the success rate of operation and postoperative complications. Hemiarthroplasty can be divided into bipolar hemiarthroplasty and unipolar hemiarthroplasty. This study systematically evaluated the clinical efficacy and safety of bipolar hemiarthroplasty and unipolar hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly so as to provide evidence-based support for prosthesis decision-making in hemiarthroplasty. METHODS: The databases including PubMed, The Cochrane Library, OVID, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were searched to collect clinical randomized controlled trials of bipolar hemiarthroplasty and unipolar hemiarthroplasty for displaced neck femoral neck fractures in elderly patients at home and abroad. The Cochrane Handbook risk assessment tool was used to evaluate the quality of the included studies. The results of the included studies were meta-analyzed by RevMan 5.3 software. RESULTS: (1) Eighteen randomized controlled clinical trials with high quality were included, with a total of 1 988 fractures patients, including 998 cases in bipolar hemiarthroplasty group and 990 cases in unipolar hemiarthroplasty group. (2) There were no statistically significant differences in mortality, dislocation of prosthesis, loosening of prosthesis, local infection, hip pain, general complication, and surgical informations between bipolar hemiarthroplasty and unipolar hemiarthroplasty (P > 0.05). (3) Harris score was higher in the bipolar hemiarthroplasty group than that in the unipolar hemiarthroplasty group (MD=1.77, 95%CI:0.94-2.61, P < 0.001). The rate of acetabular erosion in bipolar hemiarthroplasty group was lower than that in unipolar hemiarthroplasty group (RR=0.25, 95%CI:0.13-0.47, P < 0.000 1). However, two studies have reported that bipolar implants may be more costly. CONCLUSION: Compared with unipolar hemiarthroplasty, bipolar hemiarthroplasty has lower acetabular wear rate and better recovery of hip function in elderly patients with displaced fem-oral neck fracture. However, whether bipolar prosthesis has better economic benefits than uni-polar prosthesis needs further evaluation in the future. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many domestic and foreign literatures have reported that half hip replacement for unstable intertrochanteric fractures in the elderly has achieved good results, but the unstable intertrochanteric fracture with hemiarthroplasty is difficult to reconstruct the greater trochanter, and its reconstruction method is still controversial. OBJECTIVE: To discuss short-term effect of bipolar hemiarthroplasty and reconstruction of the femoral greater trochanter with cerclage band in the treatment of intertrochanteric fracture in elderly patients. METHODS: Clinical data of 15 elderly patients with intertrochanteric fracture undergoing bipolar hemiarthroplasty, and reconstruction of the femoral greater trochanter with cerclage band in the Xinjiang Uygur Autonomous Region People's Hospital were retrospectively analyzed. Posterolateral approach was selected. The patients were followed up in out-patient clinic yearly at postoperative 1, 3, 6 and 12 months. Fracture healing was judged using X-ray films, and the possibility of infection was observed. Hip function was evaluated using Harris scoring. Subjective satisfaction of patients was recorded. RESULTS AND CONCLUSION: (1) All patients walked within 3 days after operation. All patients were reviewed on time within a year. Postoperative X-ray revealed that the sample achieved initial stability, and had achieved fracture healing of greater trochanter. Blood examination did not show infection index. (2) The Harris score was (86.3±5.8) in final follow-up. Subjective satisfaction of patients was good. (3) In summary, bipolar hemiarthroplasty and reconstruction of the femoral greater trochanter with cerclage band in the treatment of intertrochanteric fracture in elderly patients can obtain good therapeutic effect, and it can achieve good prosthesis stability and large trochanter fracture reduction and fixation. [ABSTRACT FROM AUTHOR]