长期随访下全髋关节置换术采用不同关节界面Meta分析

目的：比较陶瓷-陶瓷（ceramic on ceramic,CoC）界面与聚乙烯-陶瓷（ceramic on polyethylene,CoP）界面在初次全髋关节置换术中的长期随访效果及并发症，提供临床依据。方法：检索PubMed、EMBase、CoChrane图书馆、Web of science、万方数据库和中国知网，检索时间2000年1月至2021年9月，筛选纳入关于比较陶瓷-陶瓷界面和聚乙烯-陶瓷界面在全髋关节置换长期疗效和并发症的随机对照试验的随机临床研究（randomized controlled trial,RCTs），根据纳入与排除标准进行文献筛选、质量评价及数据提取，采用Review Manager 5.3统计学软件对采用CoC或CoP术后关节功能、翻修、假体骨折、脱位、关节异响及假体磨损率进行统计分析。结果：纳入7个RCTs研究，其中CoC人工关节390髋，CoP人工关节384髋。CoC和CoP人工关节长期关节功能改善相近，差异无统计学意义[MD=0.63,95%CI(-1.81,3.07)],P=0.61；在术后并发症方面CoC人工关节有着较高的关节异响发生率[OR...

Meta-analysis of different joint interfaces in total hip arthroplasty under long-term follow-up

Objective To compare the long-term follow-up effect and complications of ceramic on ceramic (CoC) interface and ceramic on polyethyleneon ceramic (CoP) interface in primary total hip arthroplasty,and provide clinical evidence.Methods Search PubMed,EMBase,the CoChrane Library databases,Web of science,Wanfang database,and CNKI from January 2000 to September 2021,screening and inclusion of randomized controlled trials (RCTs) comparing the long-term efficacy and complications of CoC interface and CoP interface in total hip arthroplasty.Literature screening,quality evaluation and data extraction were carried out according to the inclusion and exclusion criteria,using Review Manager 5.3 statistical software.The software was used to perform statistical analysis on joint function,revision,prosthesis fracture,abnormal joint noise,and prosthesis wear rate after CoC or CoP.Results Seven RCTs studies were included,including 390 cases of hips with CoC artificial joints and 384 cases of hips with CoP artificial joints.The long-term joint function improvement of CoC and CoP artificial joints was similar and there was no significant differences,with an average difference was MD=0.63,95%CI=(-1.81,3.07),P=0.61.About the postoperative complications,CoC artificial joints have higher incidence rate of abnormal joint noise,with odds ratio (OR)=11.05,95%CI=(2.04,59.84),P=0.005.CoP artificial joints wear faster,with an average MD=-87.11,95%CI=(-114.40,-59.82),P<0.000 1.There was no significant difference between the two groups in the replacement-related complications such as joint dislocation,prosthesis loosening,osteolysis,and the rate of prosthesis revision caused by various reasons.Conclusion The clinical function results and complications of CoC artificial joints are comparable to those of CoP artificial joints.Although CoP artificial joint prosthesis has a faster wear rate,it does not affect joint function and increase complications,and there is no abnormal joint noise.CoC is expensive and the long-term efficacy is equivalent to CoP.Clinicians should consider cost performance when choosing CoC.