Trabecular metal versus non-trabecular metal acetabular components for acetabular revision surgery: A systematic review and meta-analysis

医学 入射(几何) 荟萃分析 外科 科克伦图书馆 无菌处理 关节置换术 临床终点 不利影响 髋臼 内科学 随机对照试验 光学 物理
作者
Xianyue Shen,Yanguo Qin,Yang Li,Xiongfeng Tang,Jianlin Xiao
出处
期刊:International Journal of Surgery [Wolters Kluwer]
卷期号:100: 106597-106597 被引量:11
标识
DOI:10.1016/j.ijsu.2022.106597
摘要

The objective of this study was to compare cup survival and the incidence of adverse events associated with the use of trabecular metal (TM) and non-TM cups for acetabular revision surgery.The MEDLINE, EMBASE, and Cochrane Library databases were searched for comparative studies that reported cup survival and the incidence of adverse events associated with the use of TM and non-TM cups for acetabular revision surgery. Primary outcomes included cup survival, aseptic loosening, dislocation, and infection.The meta-analysis included 6 studies that involved 13,864 total hip arthroplasty (THA) revisions who underwent acetabular revision surgery with TM (n = 5,619) or non-TM (n = 8,245) cups. The meta-analysis demonstrated no significant difference in cup survival using re-revision for any reason or aseptic loosening as the endpoint following acetabular revision surgery with TM or non-TM cups (HR = 0.96; [95% CI, 0.84-1.09]; HR = 1.29; [95% CI, 0.70-2.38]). Pooled data indicated that the overall incidence of adverse events for TM or non-TM cups was 6.8% (382/5,289) and 9.0% (725/8,083), respectively, and not significantly different (OR = 0.91; [95% CI, 0.80-1.04]). The incidence of aseptic loosening and infection were significantly lower (OR = 0.75; [95% CI, 0.58-0.96]; OR = 0.70; [95% CI, 0.54-0.90]) and the incidence of dislocation was significantly higher (OR = 1.53; [95% CI, 1.22-1.91]) for TM compared to non-TM cups.This review was the first to use reconstructed time-to-event data to find that there was no difference in survival of TM and non-TM cups in acetabular revision surgery. Overall, fewer adverse events were associated with the use of TM compared to non-TM cups, but the difference was not significant. The incidence of aseptic loosening and infection were significantly lower and the incidence of dislocation was significantly higher for TM compared to non-TM cups. This information is expected to guide orthopedic surgeons in the selection of appropriate acetabular components for THA revision.
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