髋关节表面置换与全髋关节置换疗效的Meta分析

背景：髋关节表面置换近年来得到了越来越广泛的应用,其与传统的全髋关节置换相比哪种方式的效果更好仍有较大争议。 目的：通过综合分析已发表的文献,探讨比较髋关节表面置换与传统的全髋关节置换的优缺点。 方法：检索1900年1月至2012年7月关于髋关节表面置换和全髋关节置换的随机对照研究,严格评价纳入研究质量并提取资料。采用RevMan5.1.6进行统计学Meta分析。 结果与结论：共纳入10个随机对照试验,Meta分析结果显示髋关节表面置换与全髋关节置换在平均手术时间、术中平均失血量、置换后1年Harris评分、置换后1年美国加州大学髋关节功能评分、置换后2年血清钴、铬离子水平方面均差异无显著性意义;髋关节表面置换组置换后平均髋臼倾斜角大于全髋关节置换组。结果说明髋关节表面置换和全髋关节置换的短期随访结果并无明显的差异,但二者远期效果如何需更多高质量、大样本临床随机对照试验进行评价。

Hip surface replacement and total hip arthroplasty: Meta-analysis on the efficacy

BACKGROUND: Hip surface replacement has been widely used in recent years, but there is great controversy on which works better, hip surface replacement or traditional total hip arthroplasty. OBJECTIVE:To investigate and compare the advantages and disadvantages of hip surface replacement and total hip arthroplasty trough compressive analyzing the published literatures. METHODS: The randomized controlled trials on the hip surface replacement and total hip arthroplasty from January 1900 to July 2012 were retrieved. The quality of the included randomized controlled trials was evaluated strictly. The RevMan5.1.6 was used for Meta-analysis RESULTS AND CONCLUSION: Ten randomized controlled trials were included. Results of Meta-analysis showed that there were no significant differences in operation time, intraoperative blood loss, 1 year postoperative Harris score, 1 year postoperative University of California at LosAngeles hip function score and serum levels of cobalt and chromium ion at 2 years after replacement between hip surface replacement and total hip arthroplasty. The average acetabulum anteversion angle in the hip surface replacement group was greater than that in the total hip arthroplasty group. The results indicate that there was no significant difference in the short-term follow-up between hip surface replacement and total hip arthroplasty, but the long-term effect needs to be evaluated with higher quality and larger sample clinical randomized controlled trials.