Are short-stem prostheses superior to conventional stem prostheses in primary total hip arthroplasty? A systematic review and meta-analysis of randomised controlled trials

BMJ Open
Hao-Dong LiangJun Liu

Abstract

Cementless total hip arthroplasty (THA) is associated with reliable clinical results and high patient satisfaction. Short-stem prostheses (SS) were designed to achieve superior preservation of proximal bone stock and stability compared with those of conventional-stem prostheses (CS). This meta-analysis was conducted to determine the proximal bone remodelling, revision rate, Harris Hip Score, radiolucent line and maximum total point motion values of both SS and CS for primary THA. Relevant randomised controlled trials (RCTs) involving SS and CS in primary THA were identified from electronic databases, such as EMBASE, PubMed and the Cochrane Library. Ultimately, 12 RCTs involving 1130 patients (1387 hips) were included. The results showed that compared with CS, SS resulted in less bone mineral density (BMD) changes in Gruen zone 7 at 1 year and 2 years postoperatively (mean difference (MD)=5.11; 95% CI, 1.61, 8.61; P=0.30; and MD=4.90; 95% CI, 1.01, 8.79; P=0.17, respectively). No difference in BMD changes was found for Gruen zone 1 (MD=2.66; 95% CI, -3.31, 8.64; P<0.00001), and no differences were observed for the revision rate (relative risk (RR)=1.52; 95% CI, 0.71, 3.26; P=0.94), Harris Hip Score (MD=-0.38; 95% CI, -1.02, 0.26...Continue Reading

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Citations

Nov 21, 2019·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Satish BabuJustin Cobb
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Apr 27, 2021·Journal of Orthopaedics·Marcel CoutandinKarl Philipp Kutzner
Apr 9, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Cedric MaillotCharles Rivière
Jul 25, 2021·Archives of Orthopaedic and Trauma Surgery·Marta Del Río-ArteagaJuan Ribera
Jul 25, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Sivan SivaloganathanCharles Rivière

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