Department of Orthopedic Surgery, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China.
Department of Orthopedic Surgery, Fourth Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China.
J Orthop Traumatol. 2022 Feb 10;23(1):9. doi: 10.1186/s10195-022-00629-8.
Press-fit cementless acetabular cup is widely used in total hip arthroplasty (THA). However, the use of additional screws for the acetabular cup has been extensively debated. The purpose of this review is to compare the stability, revision rate, wear rate, and clinical scores of cementless acetabular cups with and without screws in THA.
Comprehensive literature searches of the following databases were performed: Cochrane Library, Pubmed, Web of Science, OVID, Elsevier ClinicalKey, Clinicaltrials.gov, and EMBASE. We searched for trials that compared cementless acetabular cups with screws or without screws, and were published in the English language. We evaluated the stability of the prosthesis by osteolysis and migration. The clinical scores included Harris hip scores (HHS) and pain scores.
Nineteen articles involving 4046 THAs met the inclusion criteria. Our analysis revealed that additional screws did not increase the stability of acetabular cups, and there was no statistical significance between the groups with and without screws in osteolysis and clinically relevant migration. Revision rates showed no significant difference between the groups with and without screws. There was no difference in wear between the two groups. Our analysis showed no difference in pain scores and HHS between groups.
Press-fit without screws could achieve sufficient acetabular cup stability. Acetabular cups without screws showed no difference from acetabular cups with screws in many outcomes. Additional screws are not required for cementless acetabular cups.
Level III.
压配式非骨水泥髋臼杯广泛应用于全髋关节置换术（THA）。然而，髋臼杯是否使用附加螺钉仍存在广泛争议。本综述旨在比较 THA 中使用和不使用螺钉的非骨水泥髋臼杯的稳定性、翻修率、磨损率和临床评分。
对 Cochrane 图书馆、Pubmed、Web of Science、OVID、Elsevier ClinicalKey、Clinicaltrials.gov 和 EMBASE 等数据库进行全面文献检索。我们检索了比较带螺钉和不带螺钉的非骨水泥髋臼杯的试验，并以英文发表。我们通过骨溶解和迁移来评估假体的稳定性。临床评分包括 Harris 髋关节评分（HHS）和疼痛评分。
19 篇涉及 4046 例 THA 的文章符合纳入标准。我们的分析表明，附加螺钉并不能增加髋臼杯的稳定性，在骨溶解和临床上相关的迁移方面，带螺钉组和不带螺钉组之间无统计学意义。翻修率在带螺钉组和不带螺钉组之间无显著差异。两组之间的磨损无差异。我们的分析表明，两组之间的疼痛评分和 HHS 无差异。
压配式非骨水泥髋臼杯无需螺钉即可获得足够的髋臼杯稳定性。在许多结果方面，不带螺钉的髋臼杯与带螺钉的髋臼杯无差异。非骨水泥髋臼杯不需要附加螺钉。
III 级。
