关节置换术治疗急性关节内骨折股骨头置换术与全髋关节置换术治疗股骨近端骨折的比较（对2007年研究的更新）

Acute intracapsular fractures treated with arthroplastyHemiarthroplasty versus total hip arthroplasty for proximal femoral fractures （update to April 2007 report）

5项随机对照研究（RCT）或半RCT的证据提示，对于股骨近端骨折，与全髋关节置换术（THA）治疗相比，股骨头置换术（HA）治疗虽然会增加术后翻修的几率，但是术后关节脱位的发生率则明显降低。接受HA治疗的患者后期活动能力恢复可能较差，但是各研究间的统计学结果并不一致。同时基于目前报道的各种假体类型，两种治疗方法间死亡率比较差异无统计学意义。由于现有研究在方法学和假体类型选择上不一致，因此在解读本研究相关结论时仍需谨慎。

Summary Evidence from five randomized or quasi-randomized controlled trials （RCTs） suggests that for patients pre- senting with proximal femur fractures, relative to total hip arthroplasty（THA）, patients with hemiarthroplasty （HA） may be at lower risk for dislocation, although at higher risk for revision. Patients with HA may have less mobility, but statistical significance was not consistent across studies. No significant differences in mortality based on prosthesis type were reported. Results should be interpreted cautiously given lack of homogeneity with respect to methods and prostheses used.