Meta-analysis of efficacy and safety of short-stem versus long-stem hip arthroplasty

doi:10.3969/j.issn.2095-4344.1931

Abstract

Abstract:

BACKGROUND: Short hip arthroplasty has the characteristics of less trauma, stable prosthesis, biomechanics and better bone retention. However, short-stem 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%CI(3.20, 8.27), P < 0.05; MD=4.16, 95%CI(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%CI(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%CI(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%CI(0.13, 1.22), P > 0.05; MD=-0.02, 95%CI(-0.08, 0.03), P > 0.05; MD=-0.10, 95%CI(-0.16, 0.04), P > 0.05]. (3) 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.

Key words: total hip arthroplasty, long-stem hip arthroplasty, short-stem hip arthroplasty, meta-analysis, femoral head necrosis, clinical outcomes, radiological outcomes, short-term study, medium and long-term study

CLC Number:

R687.4+2

R459.9

R318.08

Liu Changlu, Ma Libo, Liu Xiaomin, Huang Jian. Meta-analysis of efficacy and safety of short-stem versus long-stem hip arthroplasty [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(3): 416-421.

Figures/Tables 10

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