摘要
背景:短柄人工髋关节系统具有创伤小、假体稳定、符合人体生物力学、更好的保留骨量等特点,但是目前短柄假体在人工髋关节置换术中应用并不广泛,人群具体受益情况仍不清楚。目的:评价长柄及短柄人工髋关节置换治疗股骨头坏死的疗效及安全性。方法:应用计算机检索PubMed数据库、Embese数据库、Medline数据库、Web of Science和Cochrane图书馆数据库,收集关于长柄及短柄髋关节置换的临床随机对照试验,对符合纳入标准的研究采用RevMan5.3软件进行Meta分析。结果与结论:①共纳入9项随机临床对照试验、747例患者,其中长柄假体组383例和短柄假体组364例;②Meta分析显示:短柄假体组术后6个月及6个月以上的髋关节Harris评分高于长柄假体组[MD=5.74,95%CI(3.20,8.27),P <0.05;MD=4.16,95%CI(2.36,5.97),P <0.05],术后WOMAN指数评分较长柄假体组明显改善[MD=10.37,95%CI(5.71,15.03),P <0.05],术后NRS疼痛评分较长柄假体组明显改善[MD=0.54,95%CI(0.18,0.90),P <0.01];两组切口感染、术后脱位、双下肢不等长、假体松动等并发症发生率与术后6个月及6个月以上的骨密度比较差异均无显著性意义[OR=0.40,95%CI(0.13,1.22),P>0.05;MD=-0.02,95%CI(-0.08,0.03),P> 0.05;MD=-0.10,95%CI(-0.16,0.04),P> 0.05];③结果表明,短柄人工髋关节置换是治疗股骨头坏死的有效方法,可缓解疼痛、尽早恢复关节功能、提高手术效果,尤其适用于骨质较好的年轻患者。
BACKGROUND: Short hip arthroplasty has the characteristics of less trauma, stable prosthesis, biomechanics and better bone retention. However, short-stem prosthesis is not widely used in hip arthroplasty at present, and the specific benefits of the population are still unclear. OBJECTIVE: To evaluate the efficacy and safety of long-and short-stem hip arthroplasty for treating femoral head necrosis. METHODS: Clinical randomized controlled trials of long-and short-stem hip arthroplasty were collected from PubMed database, Embese database, Medline database, Web of Science database and Cochrane library database. RevMan 5.3 software was used for meta-analysis of studies that met the inclusion criteria. RESULTS AND CONCLUSION:(1) Nine randomized controlled trials were involved in this study. 747 patients were divided into two groups: 383 long-stem hips and 364 short-stem hips.(2) Meta-analysis showed that hip Harris score was higher in the short-stem hip group than in the long-stem hip group at 6 months and more after surgery [MD=5.74, 95%CI(3.20, 8.27), P < 0.05;MD=4.16, 95%CI(2.36, 5.97), P < 0.05]. WOMAN index score was significantly improved in the short-stem hip group compared with the long-stem hip group after surgery [MD=10.37, 95%CI(5.71, 15.03), P < 0.05]. NRS score for hip pain was significantly improved in the short-stem hip group compared with the long-stem hip group after surgery [MD=0.54, 95%CI(0.18, 0.90), P < 0.01]. There was no significant difference in incision infection, dislocation, unequal length of lower limbs and loosening of prosthesis between the two groups compared with bone mineral density at 6 months and over 6 months after operation [OR=0.40, 95%CI(0.13, 1.22), P > 0.05;MD=-0.02, 95%CI(-0.08, 0.03), P > 0.05;MD=-0.10, 95%CI(-0.16, 0.04), P > 0.05].(3) These results indicated that short-stem hip arthroplasty is an effective method for the treatment of femoral head necrosis. It can relieve pain, restore joint function as soon as possible and improve surgical effect, especially for young patie
作者
刘长路
马丽波
刘晓民
黄健
Liu Changlu;Ma Libo;Liu Xiaomin;Huang Jian(Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,Inner Mongolia Autonomous Region,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第3期416-421,共6页
Chinese Journal of Tissue Engineering Research
基金
内蒙古自然科学基金面上项目(2016MS08129),项目负责人:刘长路~~
关键词
人工髋关节置换术
长柄髋
短柄髋
Meta分析
股骨头坏死
临床结果
影像学结果
短期研究
中长期研究
total hip arthroplasty
long-stem hip arthroplasty
short-stem hip arthroplasty
meta-analysis
femoral head necrosis
clinical outcomes
radiological outcomes
short-term study
medium and long-term study
