Department of Orthopaedics, Dr. Akbar Niazi Teaching Hospital, Islamabad, Pakistan.
Department of Orthopaedic Surgery, National University Hospital, Singapore, Singapore.
J Arthroplasty. 2020 Apr;35(4):1130-1136. doi: 10.1016/j.arth.2019.09.041. Epub 2019 Oct 4.
The aim of this meta-analysis and systematic review is to estimate re-revision rates due to aseptic loosening of retained acetabular components after revision total hip arthroplasty.
PubMed, EMBASE, Cochrane Library, and Web of Science were searched until June 11, 2018. Data were extracted by 2 independent investigators and consensus was reached with the involvement of a third investigator. Rates of re-revision due to aseptic loosening from 6 studies were aggregated using random effects model after a logit transformation and were grouped by study and population level characteristics.
An assessment of the re-revision rates of retained acetabular components due to aseptic loosening in revision total hip arthroplasty was reported in 6 studies involving 669 cases. The pooled re-revision rate was 12.6% (95% confidence interval 8.4-18.4) with a mean study follow-up of 8.6 years. The rate of re-revision due to aseptic loosening of retained acetabular components was 6.8% (95% confidence interval 3.4-13.3). In the univariate meta-regression analysis, mean age at index revision surgery was significantly associated with the rate of re-revision due to aseptic loosening (R = 99.98%, P < .0001).
Based on this exploratory analysis, revision hip procedures with retentions of well-fixed acetabular components generally have a low risk of failure during mid-term to long-term follow-ups.
本荟萃分析和系统评价旨在评估初次髋关节翻修术后因非感染性松动而导致保留髋臼部件再次翻修的翻修率。
检索 PubMed、EMBASE、Cochrane 图书馆和 Web of Science，截至 2018 年 6 月 11 日。由 2 位独立研究者提取数据，如有分歧则由第 3 位研究者达成共识。使用随机效应模型对 6 项研究中的数据进行转换后，汇总因非感染性松动而导致的再次翻修率，并按研究和人群水平特征进行分组。
有 6 项研究报告了初次髋关节翻修术后因非感染性松动而保留髋臼部件再次翻修的翻修率，涉及 669 例患者。汇总的再次翻修率为 12.6%（95%置信区间 8.4%-18.4%），平均研究随访时间为 8.6 年。因非感染性松动而导致保留髋臼部件再次翻修的比率为 6.8%（95%置信区间 3.4%-13.3%）。在单变量meta 回归分析中，初次翻修手术时的平均年龄与因非感染性松动导致的再次翻修率显著相关（R=99.98%，P<.0001）。
基于这项探索性分析，在中期至长期随访中，初次髋关节翻修手术保留固定良好的髋臼部件的翻修手术一般失败风险较低。
