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The clinical and radiological outcomes of hip resurfacing versus total hip arthroplasty: a meta-analysis and systematic review.
- Source :
- Acta Orthopaedica; Dec2010, Vol. 81 Issue 6, p684-695, 12p, 1 Diagram, 12 Charts, 1 Graph
- Publication Year :
- 2010
-
Abstract
- Background and purpose Hip resurfacing (HRS) procedures have gained increasing popularity for younger, higher-demand patients with degenerative hip pathologies. However, with concerns regarding revision rates and possible adverse metal hypersensitivity reactions with metal-on-metal articulations, some authors have questioned the hypothesized superiority of hip resurfacing over total hip arthroplasty (THA). In this meta-analysis, we compared the clinical and radiological outcomes and complication rates of these 2 procedures. Methods A systematic review was undertaken of all published (Medline, CINAHL, AMED, EMBASE) and unpublished or gray literature research databases up to January 2010. Clinical and radiological outcomes as well as complications of HRS were compared to those of THA using risk ratio, mean difference, and standardized mean difference statistics. Studies were critically appraised using the CASP appraisal tool. Results 46 studies were identified from 1,124 citations. These included 3,799 HRSs and 3,282 THAs. On meta-analysis, functional outcomes for subjects following HRS were better than or the same as for subjects with a THA, but there were statistically significantly greater incidences of heterotopic ossification, aseptic loosening, and revision surgery with HRS compared to THA. The evidence base showed a number of methodological inadequacies such as the limited use of power calculations and poor or absent blinding of both patients and assessors, possibly giving rise to assessor bias. Interpretation On the basis of the current evidence base, HRS may have better functional outcomes than THA, but the increased risks of heterotopic ossification, aseptic loosening, and revision surgery following HRS indicate that THA is superior in terms of implant survival. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANALYSIS of variance
ARTHROPLASTY
CHI-squared test
CINAHL database
COMPUTER software
CONFIDENCE intervals
MEDICAL information storage & retrieval systems
EVALUATION of medical care
MEDLINE
META-analysis
COMPLICATIONS of prosthesis
REOPERATION
RESEARCH evaluation
TOTAL hip replacement
SYSTEMATIC reviews
DATA analysis
RELATIVE medical risk
DRUG side effects
Subjects
Details
- Language :
- English
- ISSN :
- 17453674
- Volume :
- 81
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Acta Orthopaedica
- Publication Type :
- Academic Journal
- Accession number :
- 55447663
- Full Text :
- https://doi.org/10.3109/17453674.2010.533933