Meta analysis evaluates the effectiveness and safety of long-handed and short-handed hip prostheses in replacement therapy
10.3969/j.issn.2095-4344.1931
- Author:
Changlu LIU
1
Author Information
1. Second Affiliated Hospital of Inner Mongolia Medical University
- Publication Type:Journal Article
- Keywords:
Clinical outcomes;
Femoral head necrosis;
Long-stem hip arthroplasty;
Medium and long-term study;
Meta-analysis;
Radiological outcomes;
Short-stem hip arthroplasty;
Short-term study;
Total hip arthroplasty
- From:
Chinese Journal of Tissue Engineering Research
2020;24(3):416-421
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Short hip arthroplasty has the characteristics of less trauma, stable prosthesis, biomechanics and better bone retention. However, short-stern prosthesis is not widely used in hip arthroplasty at present, and the specific benefits of the population are still unclear. OBJECTIVE: To evaluate the efficacy and safety of long- and short-stem hip arthroplasty for treating femoral head necrosis. METHODS: Clinical randomized controlled trials of long-and short-stem hip arthroplasty were collected from PubMed database, Embese database, Medline database, Web of Science database and Cochrane library database. RevMan 5. 3 software was used for meta-analysis of studies that met the inclusion criteria. RESULTS AND CONCLUSION: (1) Nine randomized controlled trials were involved in this study. 747 patients were divided into two groups: 383 long-stem hips and 364 short-stem hips. (2) Meta-analysis showed that hip Harris score was higher in the short-stem hip group than in the long-stem hip group at 6 months and more after surgery [MD=5. 74, 95%C/(3. 20, 8. 27), P < 0. 05; MD=4. 16, 95%C/(2. 36, 5. 97), P < 0. 05]. WOMAN index score was significantly improved in the short-stem hip group compared with the long-stem hip group after surgery [MD= 10. 37, 95%C/(5. 71, 15. 03), P < 0. 05]. NRS score for hip pain was significantly improved in the short-stem hip group compared with the long-stem hip group after surgery [MD=0. 54, 95%C/(0. 18, 0. 90), P < 0. 01]. There was no significant difference in incision infection, dislocation, unequal length of lower limbs and loosening of prosthesis between the two groups compared with bone mineral density at 6 months and over 6 months after operation [OR=0. 40, 95%C/(0. 13, 1. 22), P > 0. 05; MD=-0. 02, 95%C/(-0. 08, 0. 03), P > 0. 05; MD=-0. 10, 95%C/(-0. 16, 0. 04), P > 0. 05], These results indicated that short-stem hip arthroplasty is an effective method for the treatment of femoral head necrosis. It can relieve pain, restore joint function as soon as possible and improve surgical effect, especially for young patients with better bone.
