Fourteen RCTs with 2,289 patients were included in the review.
Major method-related complications (11 studies, n=1,797).
There were significantly fewer major method-related complications in the arthroplasty groups than in the internal fixation groups (OR 0.11, 95% CI: 0.08, 0.15). No statistically significant heterogeneity was detected.
Reoperations (14 studies, n=2,289).
There were significantly fewer reoperations in the arthroplasty groups than in the internal fixation groups (OR 0.12, 95% CI: 0.09, 0.15). Statistically significant heterogeneity was detected.
Mortality at 1 year (14 studies, n=2,289).
There was no significant difference between the groups in 1 year mortality (OR 1.00, 95% CI: 0.81, 1.23). No statistically significant heterogeneity was detected.
Mortality at 30 days (10 studies, n=1,692).
There was no significant difference between the groups in 30-day mortality (OR 1.30, 95% CI: 0.85, 2.01) in favour of internal fixation. No statistically significant heterogeneity was detected.
Functional outcome and post-operative pain were also reported.