Abstract
Despite contradictory results of various published data on the subject, the complications of total hip arthroplasty (THA) in femoral neck fracture (FNF) compared to those in osteoarthritis (OA) are yet to be further elucidated. We queried PubMed, Cochrane, and Google Scholar from inception until October 2024 for studies that compared the surgical outcomes of THA in the management of FNF and OA. We evaluated the overall complications, such as dislocations, prosthetic joint infection (PJI), intraoperative fractures, periprosthetic fractures (PPFx), mechanical loosening, venous thromboembolism (VTE), hematoma, leg length discrepancy (LLD), and revisions. In addition, surgical parameters such as the duration of surgery and the length of stay (LOS) were also assessed. Eleven studies were included in our meta-analysis. The use of THA in FNF is associated with high risks of overall complications (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.00-2.49, P=0.05), dislocations (OR 2.12, 95% CI 1.07-4.21, P=0.03), PJI (OR 1.75, 95% CI 1.50-2.05, P<0.00001), PPFx (OR 1.62, 95% CI 1.18-2.22, P=0.003), and intraoperative fractures (OR 3.82, 95% CI 1.59-9.19, P=0.003) in comparison to those in the OA group treated with THA. FNF patients had a long LOS (mean difference=3.34, 95% CI 0.69-5.99, P=0.01). There was no statistically significant difference observed in the risk of VTE, hematoma, LLD, mechanical loosening, the number of revisions, and the duration of surgery between the FNF and OA groups, which were treated with THA. There is an increased risk of complications in patients undergoing THA for FNF than in patients undergoing THA for OA.