Mirghaderi Peyman, Eshraghi Nasim, Sheikhbahaei Erfan, Razzaghof Mohammadreza, Roustai-Geraylow Kiarash, Pouramini Alireza, Eraghi Mohammad Mirahmadi, Kafi Fatemeh, Javad Mortazavi Sayed Mohammad
Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran.
Arthroplast Today. 2024 Jan 17;25:101293. doi: 10.1016/j.artd.2023.101293. eCollection 2024 Feb.
Studies suggest tantalum (Ta) implants may have inherent antibacterial properties. However, there is no consensus regarding the effectiveness of Ta in preventing periprosthetic joint infection (PJI) after revision total hip arthroplasty (rTHA).
We searched 5 main databases for articles reporting the rate of PJI following rTHA using Ta implants from inception to February 2022. The PJI rates of the Ta group were meta-analyzed, compared with the control group, and represented as relative risks (RRs) in forest plots.
We identified 67 eligible studies (28,414 joints) for assessing the prevalence of PJI following rTHA using Ta implants. Among these studies, only 9 compared the Ta implant group with a control group. The overall PJI rate following rTHA using Ta implants was 2.9% (95% confidence interval [CI]: 2.2%-3.8%), while it was 5.7% (95% CI = 4.1%-7.8%) if only septic revisions were considered. Comparing the Ta and control groups showed a significantly lower PJI rate following all-cause rTHA with an RR = 0.80 (95% CI = 0.65-0.98, < .05). There was a trend toward lower reinfection rates in the Ta group after rTHA in septic cases, although the difference was not statistically significant (RR = 0.75, 95% CI = 0.44-1.29, = .30).
Ta implants are associated with a lower PJI rate following all-cause rTHA but not after septic causes. Despite positive results, the clinical significance of Ta still remains unclear since the PJI rate was only reduced by 20%.
IV.
研究表明钽（Ta）植入物可能具有内在抗菌特性。然而，对于钽在翻修全髋关节置换术（rTHA）后预防假体周围关节感染（PJI）的有效性尚无共识。
我们检索了5个主要数据库，以查找自开始至2022年2月报告使用钽植入物的rTHA后PJI发生率的文章。对钽组的PJI发生率进行荟萃分析，与对照组比较，并在森林图中表示为相对风险（RRs）。
我们确定了67项符合条件的研究（28414个关节），用于评估使用钽植入物的rTHA后PJI的患病率。在这些研究中，只有9项将钽植入物组与对照组进行了比较。使用钽植入物的rTHA后的总体PJI发生率为2.9%（95%置信区间[CI]：2.2%-3.8%），而仅考虑感染性翻修时为5.7%（95%CI = 4.1%-7.8%）。比较钽组和对照组显示，全因rTHA后的PJI发生率显著较低，RR = 0.80（95%CI = 0.65-0.98，P <.05）。在感染性病例的rTHA后，钽组的再感染率有降低趋势，尽管差异无统计学意义（RR = 0.75，95%CI = 0.44-1.29，P =.30）。
钽植入物与全因rTHA后的较低PJI发生率相关，但与感染性原因后的发生率无关。尽管结果呈阳性，但由于PJI发生率仅降低了20%，钽的临床意义仍不明确。
IV级。
