Table 2.
Patient Outcomes.
| Study | Intervention | N | Non-union | Internal Fixture Loosening/Failure | Other Postoperative Complications | Reoperation | Mortality | P values | Reported Conclusions |
|---|---|---|---|---|---|---|---|---|---|
| He, 2021 13 | Cannulated screw | 36 | 5.6% (2/36) | 8.3% (3/36) | Femoral neck shortening: 8.3% (3/36) | -- | -- | -- | FNS had a lower incidence of overall complications (combining non-union, nail retreat, femoral neck shortening, and internal fixation cutout) |
| FNS (DePuy synthes) | 33 | 0.0% (0/33) | 3.0% (1/33) | Femoral neck shortening: 3.0% (1/33) | -- | -- | |||
| Hu, 2021 14 | Cannulated screw | 24 | 12.5% (3/24), P = 0.795 | -- | AVN: 12.5% (3/24), Femoral neck shortening: 4.54±2.75 mm 37.5% (9/24) |
-- | -- | AVN: P = 0.389
a
Femoral neck shortening length: P = 0.005 b Femoral neck shortening incidence: P = 0.036 a |
FNS had a lower degree of femoral neck shortening and a lower incidence femoral neck shortening, but no difference in incidence of non-union or AVN. |
| FNS (DePuy synthes) | 20 | 10.0% (2/20) | -- | AVN: 5.0% (1/20) Femoral neck shortening: 2.40±1.81 mm 10.0% (2/20) |
-- | -- | |||
| Nibe, 2021 15 | Cannulated screw | 27 | 18.5% (5/27) | 7.4% (2/27) | -- | Overall: 28.6% (6/21) Conversion to HA: 11.1% (3/27) Implant removal: 11.1% (3/27) |
-- | Non-union: P = 0.052
c
Overall reoperation: P = 0.023 c |
FNS had a significantly lower incidence of reoperation |
| FNS (DePuy synthes) | 25 | 0.0% (0/25) | -- | -- | 0.0% (0/25) | -- | |||
| Tang, 2021 19 | Cannulated screw | 45 | 8.9% (4/45) | 11.1% (5/45) | AVN: 6.7% (3/45) DVT: 0.0% (0/45) |
-- | -- | Non-union: P = 0.430
a
Internal fixture loosening/failure: P = 0.481 a AVN: P = 0.356 a |
The interventions had no significant differences in patient outcomes |
| FNS (DePuy synthes) | 47 | 4.3% (2/47) | 6.4% (3/47) | AVN: 2.1% (1/47) DVT: 0.0% (0/47) |
-- | -- | |||
| Vazquez, 2021 20 | Cannulated screw | 32 | -- | -- | 3.1% (1/32) | 9.4% (3/32) | Mortality: P = 0.585 c | The interventions had no significant differences in patient outcomes | |
| Dynamic or sliding hip screw | 16 | -- | -- | -- | 0.0% (0/16) | 12.5% (2/16) | |||
| FNS (DePuy synthes) | 15 | -- | -- | -- | 0.0% (0/15) | 0.0% (0/15) | |||
| Zhang, 2022 22 | Cannulated screw | 36 | -- | -- | Femoral neck shortening: 13.89% (5/36) | Implant removal: 13.89% (5/36) | 0.0% (0/36) | Femoral neck shortening: P = 0.282
a
Implant removal: P = 0.026 a |
FNS had a lower incidence of implant removal |
| FNS (DePuy synthes) | 33 | -- | -- | Femoral neck shortening: 6.06% (2/33) | Implant removal: 0.0% (0/33) | 0.0% (0/33) | |||
| Zhou, 2021 23 | Cannulated screw | 51 | -- | -- | AVN: 0.0% (1/51) DVT: 0.0% (0/51) |
Conversion to HA: 3.9% (2/51) | -- | -- | FNS had a lower incidence of overall complications |
| FNS (DePuy synthes) | 30 | -- | -- | AVN: 0.0% (0/30) DVT: 0.0% (0/30) |
Conversion to HA: 3.3% (1/30) | -- | |||
| Niemann, 2022 16 | Dynamic or sliding hip screw | 19 | -- | -- | AVN: 0.0% (0/19) Femoral neck shortening: 0.0% (0/19) Femoral neck shortening: 0.0% (0/12) |
-- | -- | -- | The interventions had no significant differences in patient outcomes |
| FNS (DePuy synthes) | 12 | -- | -- | AVN: 0.0% (0/12) | -- | -- | -- | ||
| Schuetze, 2022 17 | Dynamic or sliding hip screw | 108 | -- | 10.2% (11/108) | Femoral neck shortening: 4.8±2.1 mm 27.7% (30/108) Hematoma: 5.6% (6/108) Surgical site infection: 2.8% (3/108) |
Conversion to THA: 8.3% (9/108) Implant removal: 1.9% (2/108) |
0.9% (1/108) | Failure, hematoma, or infection: P = 0.479
d
Femoral neck shortening: 0.455 d Mortality: >0.05 d |
The interventions had no significant differences in patient outcomes |
| FNS (DePuy synthes) | 113 | -- | 12.4% (14/113) | Femoral neck shortening: 5.3±1.9 mm 27.4% (31/113) Hematoma: 0.9% (1/113) Surgical site infection: 0.0% (0/113) |
Conversion to THA: 11.5% (13/113) Implant removal: 0.9% (1/113) |
3.5% (4/113) | |||
| Xu, 2022 21 | Cancellous screw | 51 | -- | 3.9% (2/51) | AVN: 0.0% (0/51) DVT: 0.0% (0/51) Femoral neck shortening: 1.9 mm (0.2-3.5) |
-- | -- | Internal fixture loosening/failure: P = 1.000
c
Femoral neck shortening: P = 0.452 e |
The interventions had no significant differences in patient outcomes |
| Dynamic or sliding hip screw | 52 | -- | 3.8% (2/52) | AVN: 0.0% (0/52) DVT: 0.0% (0/52) Femoral neck shortening: 2.0 mm (0.2-4.8) |
-- | -- | |||
| FNS (DePuy synthes) | 54 | -- | 5.6% (3/54) | AVN: 0.0% (0/54) DVT: 0.0% (0/54) Femoral neck shortening: 2.2 mm (0.4-4.1) |
-- | -- | |||
| Cintean, 2021 11 | FNS (DePuy synthes) | 29 | -- | -- | AVN: 0.0% (0/21) Femoral neck shortening: 3.3±4.5 mm, 100.0% (21/21) |
Overall: 13.8% (4/29) Conversion to hemiarthroplasty: 10.3% (3/29) Removal of implant: 3.4% (1/29) |
6.9% (2/29) | Mortality: P = 0.663 c | The interventions had no significant difference in patient outcomes |
| Hemiarthroplasty | 34 | -- | -- | -- | Overall: 8.8% (3/34) Conversion to HA: 2.9% (1/34) |
8.8% (3/34) | |||
| Non-comparative studies | |||||||||
| Davidson, 2022 12 | FNS (DePuy synthes) | 102 | 1.0% (1/102) | 1.0% (1/102) | AVN: 2.9% (3/102) | Conversion to THA: 8.8% (9/102) | 0.0% (0/102) | -- | No comparison between interventions |
| Stassen, 2021 18 | FNS (DePuy synthes) | 34 | -- | 5.9% (2/34) | AVN: 11.8% (4/34) | Conversion to THA: 17.6% (6/34) Implant removal: 5.9% (2/34) |
0.0% (0/34) | -- | No comparison between interventions |
Data are expressed as mean ± SD, median (IQR), or % (n) unless otherwise indicated. “--“ indicates no data reported.
AVN = avascular necrosis; DVT = deep vein thrombosis; FNS = Femoral Neck System; HA = hip arthroplasty; THA = total hip arthroplasty.
aChi-squared test of independence.
bIndependent-samples t-test.
cFisher's exact test.
dStatistical methods not clearly reported.
eKruskal-Wallis test.