Total hip replacement:A meta-analysis to evaluate survival of cemented,cementless and hybrid implants

作     者：Phedy Phedy H Dilogo Ismail Charles Hoo Yoshi P Djaja 

作者机构：Departement of Orthopaedic and TraumatologyFatmawati General HospitalFaculty of Medicine Universities Indonesia Departement of Orthopaedic and TraumatologyCiptomangunkusumo General HospitalFaculty of Medicine Universities Indonesia 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2017年第8卷第2期

页      面：192-207页

学科分类：0403[教育学-体育学] 1002[医学-临床医学] 10[医学] 

主　　题：Total hip replacement Implant survival Cemented Cementless Hybrid Meta-analysis 

摘      要：AIM To determine whether cemented, cementless, or hybrid implant was superior to the other in terms of survival rate.METHODS Systematic searches across MEDLINE, CINAHL, and Cochrane that compared cemented, cementless and hybrid total hip replacement(THR) were performed. Two independent reviewers evaluated the risk ratios of revision due to any cause, aseptic loosening, infection, and dislocation rate of each implants with a pre-determined form. The risk ratios were pooled separately for clinical trials, cohorts and registers before pooled altogether using fixed-effect model. Meta-regressions were performed to identify the source of heterogeneity. Funnel plots were analyzed. RESULTS Twenty-seven studies comprising 5 clinical trials, 9 cohorts, and 13 registers fulfilled the research criteria and analyzed. Compared to cementless THR, cemented THR have pooled RR of 0.47(95%CI: 0.45-0.48), 0.9(0.84-0.95), 1.29(1.06-1.57) and 0.69(0.6-0.79) for revision due to any reason, revision due to aseptic loosening, revision due to infection, and dislocation respectively. Compared to hybrid THR, the pooled RRs of cemented THR were 0.82(0.76-0.89), 2.65(1.14-6.17), 0.98(0.7-1.38), and 0.67(0.57-0.79) respectively. Compared to hybrid THR, cementless THR had RRs of 0.7(0.65-0.75), 0.85(0.49-1.5), 1.47(0.93-2.34) and 1.13(0.98-1.3).CONCLUSION Despite the limitations in this study, there was some tendency that cemented fixation was still superior than other types of fixation in terms of implant survival.