Table 10-40Hemiarthoplasty vs total hip replacement – Clinical study characteristics

OutcomeNumber of studiesDesignLimitationsInconsistencyIndirectnessOther considerations/imprecision
Mortality (follow up 3-6 months)174,197,3133RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (b)
Mortality (follow up 1 year)26,218,3134RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (b)
Mortality (follow up 2-4 years)11,174,197,2184RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (b)
Total no. of reoperations (follow-up 8 to 48 months)11,26,73,174,218,3136RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (b)
No. of patients reporting pain at 1 years174,3132RCTno serious limitationsserious inconsistency (d)no serious indirectnessserious imprecision (b)
Harris Hip Score for pain - 12 months261RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (c)
Failure to regain mobility (follow-up 1 to 4 years)73,3132RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (b)
Oxford Hip Score - mean of 40 months111RCTno serious limitationsno serious inconsistencyno serious indirectnessserious imprecision (c)
Barthel score - one year2181RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (c)
Barthel score - four years2181RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (c)
Hip rating questionnaire - 24 months1741RCTno serious limitationsno serious inconsistencyno serious indirectnessserious imprecision (c)
Harris Hip Score - total score - 12 months26,2182RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (c)
Harris Hip Score - total score - four years2181RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (c)
Harris Hip Score for function - 12 months261RCTserious limitations (a)no serious inconsistencyno serious indirectnessserious imprecision (c)
Short form 36 physical score - mean of 40 months111RCTno serious limitationsno serious inconsistencyno serious indirectnessserious imprecision (c)
Self reported walking distance (kilometres) - mean of 40 months111RCTno serious limitationsno serious inconsistencyno serious indirectnessserious imprecision (c)
EuroQol (EQ-5d) questionnaire - 24 months1741RCTno serious limitationsno serious inconsistencyno serious indirectnessserious imprecision (c)
Length of hospital stay1744RCTno serious limitationsno serious inconsistencyno serious indirectnessserious imprecision (c)
a

The studies with the most weight in the meta-analysis have inadequate or unclear allocation concealment.

b

The relatively few events and few patients give wide confidence intervals around the estimate of effect. This makes it difficult to know the true effect size for this outcome.

c

The wide confidence intervals around the measurement make the result imprecise. This makes it difficult to know the true effect size for this outcome.

d

There is significant heterogeneity between the studies which maybe due to the types of arthroplasty used.

From: 10, Surgical procedures

Cover of The Management of Hip Fracture in Adults
The Management of Hip Fracture in Adults [Internet].
NICE Clinical Guidelines, No. 124.
National Clinical Guideline Centre (UK).
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