Comparative efficacy of cementless bipolar hemiarthroplasty and proximal femoral nail anti-rotation in unstable intertrochanteric fractures: A meta-analysis

Table 1 Quality assessment of the included cohort studies using the Newcastle-Ottawa Scale tool

Ref.	Selection				Comparability	Outcome			Overall quality	Quality
	Representativeness of the exposed cohort	Selection of the non-exposed cohort	Ascertainment of exposure	Outcome was not present at start of study	Control of 2 important factors	Assessment of outcome	Follow-up long enough	Adequacy of follow-up of cohort	Assessment
Cai et al[26], 2022		*	*	*	**	*	*		7	Very good
Song et al[27], 2022		*	*	*	**	*	*		7	Very good
Zhou et al[28], 2019		*	*	*	**	*	*	*	8	Very good

Table 2 Characteristics of included studies

Ref.	Country	Journal	Study design	Study period	Fractures classification		Number of patients		Sex as male/female		Average age in year		Follow-up in months	Conclusion
							CBHA	PFNA	CBHA	PFNA	CBHA	PFNA
(1) Cai et al[26], 2022	China	BMC Musculoskeletal Disorders	Retrospective	June 2014 to June 2019	AO classification		36	34	16/20	16/18	82.19	80.88	24 months	Cementless bipolar hemiarthroplasty showed no obvious advantage over PFNA in the perioperative period in elderly patients with osteoporotic unstable intertrochanteric fractures. However, the joint replacement allowed for earlier ambulation after the operation and rapid recovery of the hip joint function
					Class	CBH/PFNA
					A2.2	17/22
					A2.3	19/12
(2) Song et al[27], 2022	China	BMC Musculoskeletal Disorders	Retrospective	January 2012 to December 2016	Evan-Jensen classification		30	32	9/21	5/27	81.0	79.9	12 months	The bipolar hemiarthroplasty allows an earlier return to weight-bearing activity, but ultimately has the same effective treatments as the PFNA for the elderly with unstable comminuted ITFs
					Class	CBH/PFNA
					3	5/5
					4	8/7
					5	17/20
(3) Zhou et al[28], 2019	China	BMC Musculoskeletal Disorders	Retrospective	March 2008 to December 2012	Evan-Jensen classification		47	61	27/20	36/25	83.8	83.5	Minimum 12 months	Both PFNA and Cementless bipolar hemiarthroplasty are safe and effective treatments for femoral intertrochanteric fracture in elderly patients. Nonetheless, cementless bipolar hemiarthroplasty allows faster mobilization and recovery
					Class	CBH/PFNA
					III	22/27
					IV	17/22
					V	11/12