Giovanoulis Vasileios, Kenanidis Eustathios, Aïm Florence, Gamie Zakareya, Marmor Simon, Potoupnis Michael, Lustig Sébastien, Tsiridis Eleftherios
Orthopedic Surgery Department, Groupe Hospitalier Diaconnesses Croix Saint-Simon, 125 Rue d'Avron, 75020 Paris, France - Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, 56403, Greece - Center of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation(CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, 10th km Thessaloniki-Thermi Rd, PO Box 8318, GR 57001, Greece - Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Hospices Civils de Lyon, 103 Grande Rue de La Croix Rousse, 69004 Lyon, France.
Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, 56403, Greece - Center of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation(CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, 10th km Thessaloniki-Thermi Rd, PO Box 8318, GR 57001, Greece.
SICOT J. 2024;10:8. doi: 10.1051/sicotj/2024003. Epub 2024 Feb 15.
This systematic review aims to critically assess the literature comparative studies investigating collared and collarless Corail stem in primary total hip arthroplasty (THA) to find differences in revision rates, radiographic and clinical outcomes, and postoperative complications between these two types of the same stem.
Eligible studies were found by searching PubMed, Science Direct/Scopus, and the Cochrane Database of Systematic Reviews from conception till May 2023. The PRISMA guidelines were followed. The investigation encompassed randomized controlled trials, case series, comparative, cohort, and observational studies that assessed at least one comparative outcome or complication between collared and collarless Corail stems.
Twelve comparative studies with 90,626 patients undergoing primary THA were included. There were 40,441 collared and 58,543 collarless stems. The follow-up ranged from 12 to 360 months. Our study demonstrated no significant difference in stem revision relative risk (RR = 0.68; 95% confidence interval (CI), 0.23, 2.02; p = 0.49), number of radiolucent lines (RR = 0.3; 95% CI, 0.06, 2.28; p = 0.29) and overall complication risk (RR = 0.62; 95% CI, 0.22, 1.76; p = 0.37) between collared and collarless stems. The collared stems demonstrated significantly lesser subsidence (mean difference: 1.01 mm; 95% CI, -1.77, -0.25; p = 0.009) and risk of periprosthetic fractures (RR = 0.52; 95% CI, 0.29, 0.92; p = 0.03).
The comparative studies between collared and collarless stem groups showed similar survival and overall complication rates and functional outcomes. The similar revision rates between groups make the impact of higher subsidence for collarless stems uncertain. The lower risk of periprosthetic fractures in the collared stems group must be clarified further but could be related to increased rotational stability.
本系统评价旨在严格评估有关在初次全髋关节置换术（THA）中使用带颈圈和不带颈圈的Corail柄的比较研究文献，以找出这两种相同柄型在翻修率、影像学和临床结果以及术后并发症方面的差异。
通过检索PubMed、Science Direct/Scopus以及Cochrane系统评价数据库，从建库至2023年5月找到符合条件的研究。遵循PRISMA指南。调查涵盖随机对照试验、病例系列、比较性、队列和观察性研究，这些研究评估了带颈圈和不带颈圈的Corail柄之间至少一项比较性结果或并发症。
纳入了12项比较研究，共90626例接受初次THA的患者。其中有40441个带颈圈的柄和58543个不带颈圈的柄。随访时间为12至360个月。我们的研究表明，带颈圈和不带颈圈的柄在柄翻修相对风险（RR = 0.68；95%置信区间（CI），0.23，2.02；p = 0.49）、透亮线数量（RR = 0.3；95% CI，0.06，2.28；p = 0.29）和总体并发症风险（RR = 0.62；95% CI，0.22，1.76；p = 0.37）方面无显著差异。带颈圈的柄下沉明显较小（平均差异：1.01毫米；95% CI，-1.77，-0.2 ; p = 0.009），假体周围骨折风险较低（RR = 0.52；95% CI，0.29，0.92；p = 0.03）。
带颈圈和不带颈圈的柄组之间的比较研究显示出相似的生存率、总体并发症发生率和功能结果。两组相似的翻修率使得不带颈圈的柄下沉较高的影响不确定。带颈圈的柄组假体周围骨折风险较低这一点必须进一步阐明，但可能与旋转稳定性增加有关。
