Palazzuolo Michele, Bensa Alessandro, Bauer Stefan, Blakeney William G, Filardo Giuseppe, Riegger Martin
Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6600 Locarno, Switzerland.
Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland.
J Clin Med. 2023 Mar 7;12(6):2093. doi: 10.3390/jcm12062093.
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed at comparing resurfacing hip arthroplasty (RHA) and total hip arthroplasty (THA) in terms of rate of complications, revisions, functional outcomes, blood loss, operative time and metal ions levels. The search was conducted on three databases (PubMed, Cochrane and Web of Science) updated until 13 October 2022. The inclusion criteria were RCTs) written in the English language, with no time limitation, comparing RHA and THA. Among the retrieved 4748 articles, 18 RCTs were eligible for a total of 776 patients (mean age 53.1 ± 5.0). A meta-analysis was performed. RHA reported significantly lower blood loss compared to THA ( < 0.001) but with longer operative time ( < 0.001). No statistically significant difference was found between RHA and THA in terms of complications (12.08% and 16.24%, respectively) and revisions (6.32% and 6.14%, respectively). Both RHA and THA provide excellent clinical results in a population of young and active patients. Functional outcomes were not significantly different between the groups. Moreover, no significant difference in metal ion levels was found. These findings provide evidence concerning the safety and clinical effectiveness of RHA. Because of its bone-preserving properties, the lack of drawbacks and good outcomes, RHA appears to be a valid alternative to THA in young and active patients.
本项针对随机对照试验(RCT)的系统评价和荟萃分析旨在比较髋关节表面置换术(RHA)和全髋关节置换术(THA)在并发症发生率、翻修率、功能结局、失血量、手术时间和金属离子水平方面的差异。检索了截至2022年10月13日更新的三个数据库(PubMed、Cochrane和Web of Science)。纳入标准为英文撰写的、无时间限制、比较RHA和THA的RCT。在检索到的4748篇文章中,18项RCT符合条件,共纳入776例患者(平均年龄53.1±5.0岁)。进行了荟萃分析。结果显示,与THA相比,RHA的失血量显著更低(<0.001),但手术时间更长(<0.001)。RHA和THA在并发症发生率(分别为12.08%和16.24%)和翻修率(分别为6.32%和6.14%)方面无统计学显著差异。RHA和THA在年轻、活动量较大的患者群体中均能提供出色的临床效果。两组之间的功能结局无显著差异。此外,金属离子水平也无显著差异。这些发现为RHA的安全性和临床有效性提供了证据。由于其保留骨质的特性、无明显缺点且效果良好,RHA似乎是年轻、活动量较大患者THA的有效替代方案。