Objective:To investigate the clinical efficacy and perioperative safety of simultaneous or staged bilateral total hip arthroplasty(THA)using meta-analysis.Methods:Relevant retrieval methods were developed to retrieve ...Objective:To investigate the clinical efficacy and perioperative safety of simultaneous or staged bilateral total hip arthroplasty(THA)using meta-analysis.Methods:Relevant retrieval methods were developed to retrieve PubMed,Embase,Cochrane Library,CNKI,Wanfang and VIP databases,and the time was set to build the database until September 2020.All the literatures related to simultaneous or staged total hip arthroplasty were screened out.The final included literatures were determined according to the inclusion and exclusion criteria,and the quality of the literatures was evaluated.Meta analysis of all indexes was performed using Review Manager 5.3 software.Results:A total of 22 articles were included,including 3415 patients.Meta analysis results showed that the total hospitalization time in the simultaneous group was significantly lower than that in the staged group[MD=-9.99,95%CI(-14.72,-5.26),P<0.0001].Total hospitalization expenses in the simultaneous group were lower than those in the staged group[MD=-1.3,95%CI(-1.73,-0.86),P<0.00001].The operative time in the simultaneous group was less than that in the staged group[MD=-27.08,95%CI(-40.89,-13.26),P=0.0001].The total blood loss in the simultaneous group was less than that in the staged group[MD=-176.55,95%CI(-282.5,-70.6),P=0.001].The surgical transfusion volume in the simultaneous group was higher than that in the staged group[MD=69.85,95%CI(40.48,99.22),P<0.00001].Postoperative Harris score of hip joint in the simultaneous group was higher than that in the staged group[MD=1.79,95%CI(0.8,2.79),P=0.0004].The incidence of operative complications in the simultaneous group was lower than that in the staged group[OR=0.73,95%CI(0.56,0.96),P<0.05].Conclusion:Compared with staged bilateral total hip replacement,simultaneous bilateral total hip replacement has advantages in terms of reducing hospitalization time,saving hospitalization expense,shortening operation time and reducing surgical bleeding amount,and can promote postoperative hip function recovery,reduce postoperative complications,but increase total blood transfusion volume.展开更多
目的:本文评价了滑膜切除术后联合放疗相较于单纯滑膜切除治疗膝关节色素沉着绒毛结节性滑膜炎的疗效。方法:检索SinoMed、中国知网、万方、维普、PubMed、Embase、Cochrane Library及Web of Science数据库建库至2020年10月的相关文献,...目的:本文评价了滑膜切除术后联合放疗相较于单纯滑膜切除治疗膝关节色素沉着绒毛结节性滑膜炎的疗效。方法:检索SinoMed、中国知网、万方、维普、PubMed、Embase、Cochrane Library及Web of Science数据库建库至2020年10月的相关文献,筛选滑膜切除术后联合放疗的相关文献,符合纳排标准的文献根据其研究类型选择相应的评价方法进行质量评价,采用RevMan 5.3软件行meta分析。主要结局指标为复发情况;次要结局指标为并发症、膝关节功能优良率、膝关节活动度、膝关节Lysholm评分及IKDC评分等。结果:共纳入11篇文献,研究对象510例,联合组280例,对照组230例。Meta分析结果显示:(1)联合组的复发率明显低于对照组[OR=0.33,95%CI(0.20,0.55),P<0.0001]。(2)联合组并发症明显高于对照组[OR=2.70,95%CI(1.16,6.31),P=0.02]。(3)优良率方面,联合组明显优于对照组[OR=2.86,95%CI(1.23,6.64),P=0.01],也有可能是各个研究评价优良的标准不一样导致的结果。(4)膝关节活动度MD=2.96,95%CI(-0.54,6.47),P=0.10;Lysholm评分MD=3.22,95%CI(-0.51,6.96),P=0.09;IKDC评分MD=2.88,95%CI(-1.07,6.82),P=0.15。在膝关节活动度、Lysholm评分及IKDC评分方面,两组未见显著差异。结论:膝关节色素沉着绒毛结节性滑膜炎行滑膜切除术后联合放疗可以降低复发率,但与单纯手术相比存在较高的并发症。上述结论尚需更多高质量的临床研究长期随访进行验证。展开更多
基金This study is supported by the General Project of National Natural Science Foundation of China(No.81873327)the Youth Project of National Natural Science Foundation of China(No.81904226)。
文摘Objective:To investigate the clinical efficacy and perioperative safety of simultaneous or staged bilateral total hip arthroplasty(THA)using meta-analysis.Methods:Relevant retrieval methods were developed to retrieve PubMed,Embase,Cochrane Library,CNKI,Wanfang and VIP databases,and the time was set to build the database until September 2020.All the literatures related to simultaneous or staged total hip arthroplasty were screened out.The final included literatures were determined according to the inclusion and exclusion criteria,and the quality of the literatures was evaluated.Meta analysis of all indexes was performed using Review Manager 5.3 software.Results:A total of 22 articles were included,including 3415 patients.Meta analysis results showed that the total hospitalization time in the simultaneous group was significantly lower than that in the staged group[MD=-9.99,95%CI(-14.72,-5.26),P<0.0001].Total hospitalization expenses in the simultaneous group were lower than those in the staged group[MD=-1.3,95%CI(-1.73,-0.86),P<0.00001].The operative time in the simultaneous group was less than that in the staged group[MD=-27.08,95%CI(-40.89,-13.26),P=0.0001].The total blood loss in the simultaneous group was less than that in the staged group[MD=-176.55,95%CI(-282.5,-70.6),P=0.001].The surgical transfusion volume in the simultaneous group was higher than that in the staged group[MD=69.85,95%CI(40.48,99.22),P<0.00001].Postoperative Harris score of hip joint in the simultaneous group was higher than that in the staged group[MD=1.79,95%CI(0.8,2.79),P=0.0004].The incidence of operative complications in the simultaneous group was lower than that in the staged group[OR=0.73,95%CI(0.56,0.96),P<0.05].Conclusion:Compared with staged bilateral total hip replacement,simultaneous bilateral total hip replacement has advantages in terms of reducing hospitalization time,saving hospitalization expense,shortening operation time and reducing surgical bleeding amount,and can promote postoperative hip function recovery,reduce postoperative complications,but increase total blood transfusion volume.
文摘目的:本文评价了滑膜切除术后联合放疗相较于单纯滑膜切除治疗膝关节色素沉着绒毛结节性滑膜炎的疗效。方法:检索SinoMed、中国知网、万方、维普、PubMed、Embase、Cochrane Library及Web of Science数据库建库至2020年10月的相关文献,筛选滑膜切除术后联合放疗的相关文献,符合纳排标准的文献根据其研究类型选择相应的评价方法进行质量评价,采用RevMan 5.3软件行meta分析。主要结局指标为复发情况;次要结局指标为并发症、膝关节功能优良率、膝关节活动度、膝关节Lysholm评分及IKDC评分等。结果:共纳入11篇文献,研究对象510例,联合组280例,对照组230例。Meta分析结果显示:(1)联合组的复发率明显低于对照组[OR=0.33,95%CI(0.20,0.55),P<0.0001]。(2)联合组并发症明显高于对照组[OR=2.70,95%CI(1.16,6.31),P=0.02]。(3)优良率方面,联合组明显优于对照组[OR=2.86,95%CI(1.23,6.64),P=0.01],也有可能是各个研究评价优良的标准不一样导致的结果。(4)膝关节活动度MD=2.96,95%CI(-0.54,6.47),P=0.10;Lysholm评分MD=3.22,95%CI(-0.51,6.96),P=0.09;IKDC评分MD=2.88,95%CI(-1.07,6.82),P=0.15。在膝关节活动度、Lysholm评分及IKDC评分方面,两组未见显著差异。结论:膝关节色素沉着绒毛结节性滑膜炎行滑膜切除术后联合放疗可以降低复发率,但与单纯手术相比存在较高的并发症。上述结论尚需更多高质量的临床研究长期随访进行验证。
