Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.

<h4>Background</h4>Evolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR) have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Alexander Tsertsvadze, Amy Grove, Karoline Freeman, Rachel Court, Samantha Johnson, Martin Connock, Aileen Clarke, Paul Sutcliffe
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7c4c5e41675b4bc8acf0611db6b585d1
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7c4c5e41675b4bc8acf0611db6b585d1
record_format	dspace
spelling	oai:doaj.org-article:7c4c5e41675b4bc8acf0611db6b585d12021-11-25T06:09:25ZTotal hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.1932-620310.1371/journal.pone.0099804https://doaj.org/article/7c4c5e41675b4bc8acf0611db6b585d12014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25003202/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Evolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR) have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted. This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip.<h4>Methods</h4>A comprehensive literature search was undertaken in major health databases. Randomised controlled trials (RCTs) and systematic reviews published from 2008 onwards comparing different types of primary THR in patients with end stage arthritis of the hip were included.<h4>Results</h4>Fourteen RCTs and five systematic reviews were included. Patients experienced significant post-THR improvements in Harris Hip scores, but this did not differ between impact types. There was a reduced risk of implant dislocation after receiving a larger femoral head size (36 mm vs. 28 mm; RR = 0.17, 95% CI: 0.04, 0.78) or cemented cup (vs. cementless cup; pooled odds ratio: 0.34, 95% CI: 0.13, 0.89). Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision. There was no impact of femoral stem fixation and cup shell design on implant survival rates. Evidence on mortality and complications (aseptic loosening, femoral fracture) was inconclusive.<h4>Conclusions</h4>The majority of evidence was inconclusive due to poor reporting, missing data, or uncertainty in treatment estimates. The findings warrant cautious interpretation given the risk of bias (blinding, attrition), methodological limitations (small sample size, low event counts, short follow-up), and poor reporting. Long-term pragmatic RCTs are needed to allow for more definitive conclusions. Authors are encouraged to specify the minimal clinically important difference and power calculation for their primary outcome(s) as well CONSORT, PRISMA and STROBE guidelines to ensure better reporting and more reliable production and assessment of evidence.Alexander TsertsvadzeAmy GroveKaroline FreemanRachel CourtSamantha JohnsonMartin ConnockAileen ClarkePaul SutcliffePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e99804 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alexander Tsertsvadze Amy Grove Karoline Freeman Rachel Court Samantha Johnson Martin Connock Aileen Clarke Paul Sutcliffe Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
description	<h4>Background</h4>Evolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR) have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted. This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip.<h4>Methods</h4>A comprehensive literature search was undertaken in major health databases. Randomised controlled trials (RCTs) and systematic reviews published from 2008 onwards comparing different types of primary THR in patients with end stage arthritis of the hip were included.<h4>Results</h4>Fourteen RCTs and five systematic reviews were included. Patients experienced significant post-THR improvements in Harris Hip scores, but this did not differ between impact types. There was a reduced risk of implant dislocation after receiving a larger femoral head size (36 mm vs. 28 mm; RR = 0.17, 95% CI: 0.04, 0.78) or cemented cup (vs. cementless cup; pooled odds ratio: 0.34, 95% CI: 0.13, 0.89). Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision. There was no impact of femoral stem fixation and cup shell design on implant survival rates. Evidence on mortality and complications (aseptic loosening, femoral fracture) was inconclusive.<h4>Conclusions</h4>The majority of evidence was inconclusive due to poor reporting, missing data, or uncertainty in treatment estimates. The findings warrant cautious interpretation given the risk of bias (blinding, attrition), methodological limitations (small sample size, low event counts, short follow-up), and poor reporting. Long-term pragmatic RCTs are needed to allow for more definitive conclusions. Authors are encouraged to specify the minimal clinically important difference and power calculation for their primary outcome(s) as well CONSORT, PRISMA and STROBE guidelines to ensure better reporting and more reliable production and assessment of evidence.
format	article
author	Alexander Tsertsvadze Amy Grove Karoline Freeman Rachel Court Samantha Johnson Martin Connock Aileen Clarke Paul Sutcliffe
author_facet	Alexander Tsertsvadze Amy Grove Karoline Freeman Rachel Court Samantha Johnson Martin Connock Aileen Clarke Paul Sutcliffe
author_sort	Alexander Tsertsvadze
title	Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
title_short	Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
title_full	Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
title_fullStr	Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
title_full_unstemmed	Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
title_sort	total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/7c4c5e41675b4bc8acf0611db6b585d1
work_keys_str_mv	AT alexandertsertsvadze totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT amygrove totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT karolinefreeman totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT rachelcourt totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT samanthajohnson totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT martinconnock totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT aileenclarke totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis AT paulsutcliffe totalhipreplacementforthetreatmentofendstagearthritisofthehipasystematicreviewandmetaanalysis
_version_	1718414110847139840

Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.

Ejemplares similares