Department of Joint Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, PR China.
Department of Scientific Bureau, The Third Hospital of Hebei Medical University, Hebei, 050051, PR China.
Int J Surg. 2017 Feb;38:123-129. doi: 10.1016/j.ijsu.2016.12.122. Epub 2016 Dec 31.
No formal systematic review or meta-analysis was performed up to now to summarize the risk factors of dislocation after revision total hip arthroplasty(THA).
The present study aimed to quantitatively and comprehensively conclude the risk factors of dislocation after revision total hip arthroplasty.
A search was applied to CNKI, Embase, Medline, and Cochrane central database (all up to October 2016). All studies assessing the risk factors of dislocation after revision THA without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle-Ottawa Scale. Data were pooled and a meta-analysis completed.
A total of 8 studies were selected, which altogether included 4656 revision THAs. 421 of them were cases of dislocation occurred after surgery, suggesting the accumulated incidence of 9.04%. Results of meta-analyses showed that age at surgery (standardized mean difference -0.222; 95% CI -0.413-0.031), small-diameter femoral heads (≤28 mm) (OR 1.451; 95%CI 1.056-1.994), history of instability (OR 2.739; 95%CI 1.888-3.974), number of prior revisions ≥ 3 (OR, 2.226; 95% CI, 1.569-3.16) and number of prior revisions ≥ 2 (OR 1.949; 95% CI 1.349-2.817), acetabular components with elevated rim liner were less likely to develop dislocation after revision THA (OR 0.611; 95% CI 0.415-0.898).
Related prophylaxis strategies should be implemented in patients involved with above-mentioned risk factors to prevent dislocation after revision THA.
目前尚无正式的系统评价或荟萃分析来总结翻修全髋关节置换术后脱位的危险因素。
本研究旨在定量和全面地总结翻修全髋关节置换术后脱位的危险因素。
检索中国知网、Embase、Medline 和 Cochrane 中心数据库（均截至 2016 年 10 月），纳入所有评估翻修全髋关节置换术后脱位危险因素的研究，采用纽卡斯尔-渥太华量表评价纳入研究的质量。对数据进行汇总并完成荟萃分析。
共纳入 8 项研究，共 4656 例翻修全髋关节置换术。其中 421 例术后发生脱位，累积发生率为 9.04%。荟萃分析结果显示，手术时年龄（标准化均数差-0.222；95%可信区间-0.413～0.031）、小直径股骨头（≤28 mm）（比值比 1.451；95%可信区间 1.056～1.994）、既往不稳定史（比值比 2.739；95%可信区间 1.888～3.974）、翻修次数≥3 次（比值比 2.226；95%可信区间 1.569～3.16）和翻修次数≥2 次（比值比 1.949；95%可信区间 1.349～2.817）、髋臼侧使用高边内衬的假体更不易发生翻修全髋关节置换术后脱位（比值比 0.611；95%可信区间 0.415～0.898）。
对于具有上述危险因素的患者，应采取相关预防策略，以预防翻修全髋关节置换术后脱位。
