A comparison of short-stem prostheses and conventional stem prostheses in primary total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials.

作者: Yihe Hu , Long Wang , Jingyi Li , Yixiao Pan , Qiqi Xing

DOI: 10.21037/ATM-20-4043

关键词:

摘要: Background In total hip arthroplasty (THA), short-stem prostheses (SS) were designed to achieve better preservation of proximal femoral bone stock and stability than conventional stem (CS), however these effects are controversial. We aimed perform a systematic review meta-analysis evaluate the effectiveness SS CS in primary THA. Methods Relevant randomized controlled trials (RCTs) involving comparison THA screened using electronic databases PubMed, Embase Web Science. Data analyzed with RevMan 5.3 software program evaluated mean difference (MD), risk ratio (RR) 95% confidence intervals (CIs) by random or fixed-effect models. Results Sixteen RCTs 1,233 patients (1,486 hips) included. Compared CS, incidence thigh pain was significantly reduced Proxima (RR 0.13, CI, 0.03-0.51; P=0.004). Bone mineral density (BMD) neck-preserved [SS (I)] showed less decrease Gruen zone 1 (MD 14.60, 10.67-18.54; P<0.00001) 7 9.72, 5.21-14.23; P<0.0001) CS. However, changes BMD not different between without neck group (II)] group. addition, no significant differences found revision rate, Harris Hip Score (HHS), maximum point motion (MTPM) groups. Conclusions The results this study that compared decreased (I) provided remodeling But rates, HHS, MTPM similar. findings require further verification high-quality RCTs.

参考文章(33)
Carlos Lavernia, Michele D’Apuzzo, Victor Hernandez, David Lee, Thigh pain in primary total hip arthroplasty: the effects of elastic moduli. Journal of Arthroplasty. ,vol. 19, pp. 10- 16 ,(2004) , 10.1016/J.ARTH.2004.06.023
R. W. McCalden, A. Korczak, L. Somerville, X. Yuan, D. D. Naudie, A randomised trial comparing a short and a standard-length metaphyseal engaging cementless femoral stem using radiostereometric analysis Journal of Bone and Joint Surgery-british Volume. pp. 595- 602 ,(2015) , 10.1302/0301-620X.97B5.34994
Young-Hoo Kim, Yoowang Choi, Jun-Shik Kim, Comparison of Bone Mineral Density Changes Around Short, Metaphyseal-Fitting, and Conventional Cementless Anatomical Femoral Components The Journal of Arthroplasty. ,vol. 26, pp. 931- 940.e1 ,(2011) , 10.1016/J.ARTH.2010.10.001
Steven M. Kurtz, Edmund Lau, Kevin Ong, Ke Zhao, Michael Kelly, Kevin J. Bozic, Future Young Patient Demand for Primary and Revision Joint Replacement: National Projections from 2010 to 2030 Clinical Orthopaedics and Related Research®. ,vol. 467, pp. 2606- 2612 ,(2009) , 10.1007/S11999-009-0834-6
S. D. Stulberg, R. M. Patel, The short stem: promises and pitfalls Journal of Bone and Joint Surgery-british Volume. pp. 57- 62 ,(2013) , 10.1302/0301-620X.95B11.32936
Lars V Carlsson, Björn E J Albrektsson, Björn G Albrektsson, Tomas O Albrektsson, C Magnus Jacobsson, Warren Macdonald, Lars Regnér, Tord Röstlund, Lars R Weidenhielm, Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: I. Preliminary investigations--52 patients followed for 3 years. Acta Orthopaedica. ,vol. 77, pp. 549- 558 ,(2006) , 10.1080/17453670610012601
Claudio C. Castelli, Luigi Rizzi, Short stems in total hip replacement: current status and future Hip International. ,vol. 24, pp. 25- 28 ,(2014) , 10.5301/HIPINT.5000169
Julian PT Higgins, Douglas G Altman, Peter C Gøtzsche, Peter Jüni, David Moher, Andrew D Oxman, Jelena Savović, Kenneth F Schulz, Laura Weeks, Jonathan AC Sterne, The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials BMJ. ,vol. 343, ,(2011) , 10.1136/BMJ.D5928
Harpal S Khanuja, Samik Banerjee, Deepak Jain, Robert Pivec, Michael A Mont, Short bone-conserving stems in cementless hip arthroplasty. Journal of Bone and Joint Surgery, American Volume. ,vol. 96, pp. 1742- 1752 ,(2014) , 10.2106/JBJS.M.00780