Department of Orthopaedic Surgery, Medisch Spectrum Twente, P.O. Box 50000 , 7500, KA Enschede, The Netherlands.
Int Orthop. 2011 Aug;35(8):1109-18. doi: 10.1007/s00264-011-1234-6. Epub 2011 Mar 15.
Total hip arthroplasty has been a very succesful orthopaedic procedure. The optimal fixation method of the acetabular component however, has not yet been defined.
We performed a systematic review using the Medline and Embase databases to find evidence for the superiority of cemented or cementless acetabular components on short- and long-term clinical and radiological parameters. Methodological quality for randomised trials was assessed using the van Tulder checklist, and for the non randomised studies we used the Newcastle-Ottawa quality assessment scale.
Our search strategy revealed 16 randomised controlled trials (RCT) and 19 non RCT studies in which cemented and cementless acetabular components are compared. A best evidence analysis for complications, wear, osteolysis, migration and clinical scores showed no superiority for either cemented or cementless socket in the RCTs. A best evidence analysis for non RCT studies revealed better osteolysis, migration properties and aseptic loosening survival for cementless sockets; however, wear and overall survival favoured the cemented sockets.
We recommend that an orthopaedic surgeon should choose an established cemented or cementless socket for hip replacement based on patient characteristics, knowledge, experience and preference.
全髋关节置换术是一种非常成功的矫形手术。然而，髋臼部件的最佳固定方法尚未确定。
我们使用 Medline 和 Embase 数据库进行了系统评价，以寻找有关短期和长期临床和影像学参数方面，骨水泥固定或非骨水泥固定髋臼部件具有优势的证据。使用 van Tulder 清单评估随机试验的方法学质量，对于非随机研究，我们使用纽卡斯尔-渥太华质量评估量表。
我们的搜索策略显示了 16 项随机对照试验（RCT）和 19 项比较骨水泥固定和非骨水泥固定髋臼部件的非随机研究。对并发症、磨损、骨溶解、迁移和临床评分的最佳证据分析表明，RCT 中骨水泥固定或非骨水泥固定的髋臼部件均没有优势。对非随机研究的最佳证据分析表明，非骨水泥固定的髋臼具有更好的骨溶解、迁移特性和无菌性松动存活率；然而，磨损和总体存活率则有利于骨水泥固定的髋臼。
我们建议，骨科医生应根据患者特点、知识、经验和偏好，选择已确立的骨水泥固定或非骨水泥固定的髋臼进行髋关节置换。
