骨水泥型、非骨水泥型及杂交型假体在人工全髋关节置换术后翻修率的系统评价

A Systematic Review of Revision of Cemented,Uncemented and Hybrid Prosthesis after Total Hip Arthroplasty

目的:评价骨水泥型、非骨水泥型及杂交型假体在人工全髋关节置换术(THA)后的翻修率。方法:计算机检索PubMed、OVID、Highwire、Medline、Cochrane图书馆、EMBASE、中国期刊全文数据库、中国生物医学文献光盘数据库,收集所有有关骨水泥、非骨水泥及杂交型假体在人工THA后翻修率的随机对照试验或临床对照试验的文献,筛选出符合纳入标准的文献,对其进行严格的质量评价,利用RevMan 4.2.10软件对纳入文献的研究结果进行Meta分析。THA后以髋臼假体或股骨假体或两者均需要翻修作为翻修标准。结果:共检索到相关文献2 134篇,最终纳入23个随机对照试验或临床对照试验(全部为英文文献)。当患者无年龄限制时,Meta分析结果显示:①骨水泥型与非骨水泥型假体导致的翻修率均无统计学意义。②骨水泥型与非骨水泥型髋臼假体导致的翻修率无统计学意义,骨水泥型与非骨水泥型股骨假体导致的翻修率有统计学意义(P<0.05)。③非骨水泥型与杂交型假体或骨水泥型与杂交型假体导致的翻修率均无统计学意义。结论:无年龄限制时,非骨水泥型股骨假体相对于骨水泥型假体的翻修率较低。

Objective： To evaluate the revision of cemented, uncemcntcd and hybrid prosthesis after total hip arthmplasty（THA）. Methods： Tow thousands one hundred and thirty-four case-control references about the revision of cemented, uncemented and hybrid prosthesis after THA were picked out after the comprehensive search of PubMed, OVID, Highwire, Medline, Cochrane library, EMBASE, Chinese Journal Full-text Database, Chinese Biomedical Literature Database CD-ROM（CBMdisc）, and finally 23 ones met the including criteria. And all data were analyzed by RevMan 4.2.10 software. The failure of THA was defined as that revision of either aeetabulum or shaft of femoral or both components. Results： Comparing of cemented and uncemented prosthesis, when the patients age was no limit, no significant survival was showed among groups separately. Also to the prosthesis in acetabulum, no significant survival was showed in the group, while survival in that of shaft of femoral had statistically significant（ P 〈 0.05）. Between the uncemented and hybrid prosthesis, no significant survival was showed in the group, similary to that of cemented and hybrid prosthesis. Conclusion： When there is no age limit, the revision of uneemented fixation in shaft of femoral is lower, compared to that of cemented fixation.