Hanif Muhammad, Arshad Naveed, Habib Yasir, Shami Ali Miraj, Rehman Obaid Ur, Rehman Muhammad, Reyaz Muddasir, Mumtaz Hassan
Islamabad Medical and Dental College.
Shifa International hospital.
Ann Med Surg (Lond). 2023 Apr 16;85(6):2884-2895. doi: 10.1097/MS9.0000000000000734. eCollection 2023 Jun.
Aseptic stem loosening after total hip arthroplasty surgery is the commonest complication, whether stem is cemented or uncemented. The aseptic cemented stem loosening has been a challenging problem over the years and a leading cause for revision since the inception of total hip arthroplasty. The objective of systematic review and meta-analysis was to determine the impact of cementing technique on aseptic stem loosening in total hip arthroplasty.
Cochrane, CINAHL, Embase, Google scholar, Medline, PubMed were searched in 13 December 2020. Two independent investigators extracted the data and a third investigator's involvement was reached on consensus. A total of 37 studies of revision rate due to aseptic loosening were reviewed by using fixed/random effects size and were grouped by cementing technique and studies' characteristics. The data were analyzed through Meta-Essentials and RStudio.
In revision total hip arthroplasty, retained femoral components revisions rate due to aseptic loosening were recorded in 37 studies involving 6167 cases. Aseptic loosening rate collectively was 5.8% (CI 95%, 0.03-0.08) and mean follow-up of study was 12.5 years. The average follow-up period, mean age at index revision surgery and percentage of aseptic loosening were insignificantly associated with revision rate (≥0.05), in meta-regression univariant analyses.
This investigative analysis showed that there is a minimal difference between results of cementing techniques of total hip arthroplasty in femoral components in long-term follow-ups, and usually have a low risk of failure.
全髋关节置换术后无菌性假体柄松动是最常见的并发症，无论假体柄是否使用骨水泥固定。多年来，无菌性骨水泥固定假体柄松动一直是一个具有挑战性的问题，自全髋关节置换术开展以来，一直是翻修手术的主要原因。本系统评价和荟萃分析的目的是确定骨水泥固定技术对全髋关节置换术中无菌性假体柄松动的影响。
于2020年12月13日检索Cochrane、CINAHL、Embase、谷歌学术、Medline、PubMed数据库。两名独立研究者提取数据，第三名研究者参与并达成共识。通过固定/随机效应量对37项因无菌性松动导致的翻修率研究进行综述，并按骨水泥固定技术和研究特征进行分组。通过Meta-Essentials和RStudio对数据进行分析。
在翻修的全髋关节置换术中，37项研究共纳入6167例病例，记录了因无菌性松动导致的保留股骨组件翻修率。无菌性松动率总体为5.8%（95%CI，0.03 - 0.08），研究的平均随访时间为12.5年。在Meta回归单变量分析中，平均随访期、初次翻修手术时的平均年龄和无菌性松动百分比与翻修率无显著相关性（≥0.05）。
本研究分析表明，在长期随访中，全髋关节置换术股骨组件骨水泥固定技术的结果差异极小，且通常失败风险较低。
