Efficacy and Safety of Acetabular Cup without Screw Fixation in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Participants
2.3. Interventions and Comparators
2.4. Outcome Measures
2.5. Search Strategy and Study Selection
2.6. Data Extraction and Quality Assessment
2.7. Measurement of Treatment Effect
2.8. Data Analysis and Synthesis
2.9. Certainty of Evidence
2.10. Sensitivity Analysis
2.11. Difference between Protocol and Review
3. Results
3.1. Study Selection
3.2. Primary Outcomes
3.2.1. Reoperation
3.2.2. Cup Migration
3.2.3. HHS
3.3. Secondary Outcomes
3.3.1. Radiolucent Line in Acetabular Regions
3.3.2. Translation and Rotation
3.3.3. Polyethylene Wear
3.4. All Adverse Events
4. Discussion
4.1. Summary of Main Results
4.2. Strengths
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Authors [Ref. No.] | Year | Country | Number of Hips (No Screw/Screw) | Age (SD; Years) (No Screw/Screw) | Surgical Approach | Materials of Acetabular Cup | Femoral Stem/Femoral Head/Liner | Follow-Up Period (Years) |
---|---|---|---|---|---|---|---|---|
Thanner et al. [13] | 2000 | Sweden | 34/30 | 56 (10.8)/56 (10.8) | Modified Hardinge | Titanium fiber–metal cup | Uncemented; cemented/ceramic; cobalt-chrome/PE | 2 |
Otten et al. [8,14] | 2015 | Sweden | 17/17 | 55 (6.5)/56 (6.3) | Posterolateral | Porous-coated titanium alloy cup | Cemented; cementless/ceramic/PE | 14 |
Minten et al. [11,12] | 2016 | The Netherlands | 19/17 | 69 (8.4)/70 (5.5) | Posterolateral | All polyethylene, press-fit cup with titanium coating | Cementless/ceramic/PE | 6.5 |
Howie et al. [10] | 2020 | Australia | 35/31 | 58 (5.8)/57 (5.3) | Posterior | Tantalum trabecular metal (no screw)/titanium fiber-metal (screw) | Cemented/cobalt-chrome/PE | 2 |
Outcomes | No. of Participants (No. of RCTs) | Certainty of the Evidence (GRADE) | RR (95% CI) | Anticipated Absolute Effects | |
---|---|---|---|---|---|
Risk with Screw | Risk Difference without Screw | ||||
Reoperation | 183 (4) | ⨁◯◯◯* Very low a,b,c | 0.98 (0.14–6.68) | 22 per 1000 | 0 fewer per 1000 (19 fewer to 128 more) |
Migration of acetabular cup | 140 (3) | ⨁◯◯◯ Very low a,b,c | 1.72 (0.29–10.33) | 15 per 1000 | 11 more per 1000 (11 fewer to 141 more) |
Harris Hip Score | 162 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, 89–99 | MD 1.19 higher (1.31 lower to 3.7 higher) | |
Radiolucent line | 57 (1) | ⨁◯◯◯ Very low a,b,c | 5.91 (0.32–109.35) | 0 per 1000 | 0 fewer per 1000 (0 fewer to 0 fewer) |
Cup translation: medial–lateral | 153 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, −0.09–0.58 | MD 0.08 lower (0.34 lower to 0.19 higher) | |
distal–proximal | 153 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, 0.12–0.29 | MD 0.01 lower (0.15 lower to 0.12 higher) | |
anterior–posterior | 153 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, −0.02–0.81 | MD 0.19 lower (0.52 lower to 0.13 higher) | |
transverse | 153 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, 0.13–1.32 | MD 0.25 lower (1.1 lower to 0.59 higher) | |
longitudinal | 153 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, −0.14–1.52 | MD 0.43 lower (1.44 lower to 0.58 higher) | |
sagittal | 153 (4) | ⨁◯◯◯ Very low a,b,c | Mean range, −0.13–1.06 | MD 0.16 lower (0.73 lower to 0.4 higher) | |
Polyethylene wear | 87 (3) | ⨁◯◯◯ Very low a,b,c | Mean range, 0.07–0.19 | MD 0.01 higher
(0.01 lower to 0.04 higher) |
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Miura, T.; Kijima, H.; Kimura, R.; Watanabe, J.; Okazaki, Y.; Miyakoshi, N. Efficacy and Safety of Acetabular Cup without Screw Fixation in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. Medicina 2022, 58, 1058. https://doi.org/10.3390/medicina58081058
Miura T, Kijima H, Kimura R, Watanabe J, Okazaki Y, Miyakoshi N. Efficacy and Safety of Acetabular Cup without Screw Fixation in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. Medicina. 2022; 58(8):1058. https://doi.org/10.3390/medicina58081058
Chicago/Turabian StyleMiura, Takanori, Hiroaki Kijima, Ryota Kimura, Jun Watanabe, Yuji Okazaki, and Naohisa Miyakoshi. 2022. "Efficacy and Safety of Acetabular Cup without Screw Fixation in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis" Medicina 58, no. 8: 1058. https://doi.org/10.3390/medicina58081058