全髋置换术与全髋表面置换术治疗骨关节炎的Meta分析_《中国循证医学杂志》

作者：

张紫豪 ,  沈彬 , 杨静 , 周宗科 , 康鹏德 , 裴福兴

四川大学华西医学骨科（成都 610041）;

关键词：

全髋置换术全髋表面置换术骨关节炎系统评价 Meta分析随机对照试验

DOI：

10.7507/1672-2531.20130170

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价全髋置换术（THA）与全髋表面置换术（THRA）治疗骨关节炎的疗效和安全性。
方法　计算机检索PubMed、The Cochrane Library（2012年3期）、EMbase、PLoS、美国国立卫生院临床试验库、澳大利亚国家关节置换注册网、英国国家关节注册网、英国骨科协会网（BOA）、加拿大骨科协会网（COA）、美国骨科医师学会网（AAOS）、德国医疗文档和信息学会网（DIMDI）和CBM等数据库，全面收集THA与THRA治疗骨关节炎的随机对照试验（RCT），检索时限均为建库至2012年11月，并追溯纳入研究的参考文献。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后，采用RevMan 5.1软件进行Meta分析。
结果　纳入6个RCT（涉及10篇文献），共518例患者，其中全髋置换术259例，全髋表面置换术259例。8篇文献偏倚风险为中等，2篇文献偏倚风险为低。Meta分析结果显示，术后早期，THA与THRA相比，THA为患者带来更大的股骨偏心距改善；但两组患者在Merle d’Aubigné Postel评分、WOMAC评分、UCLA评分、SF-36生活质量量表、步速、步幅、步行节律、术后双下肢不等长程度以及并发症发生率方面，差异无统计学意义。
结论　现有证据显示，THA手术改善患者股骨偏心距的效果较THRA更好，两种术式在其他指标方面无显著差异。

引用本文： 张紫豪,沈彬,杨静,周宗科,康鹏德,裴福兴. 全髋置换术与全髋表面置换术治疗骨关节炎的Meta分析. 中国循证医学杂志, 2013, 13(8): 978-984. doi: 10.7507/1672-2531.20130170 复制

1.	Berry DJ. Primary total hip arthroplasty. In: Chapman MW, ed. Chapman’s Orthopaedic Surgery. Philadelphia: Lippincott Williams & Wilkins, 2001: 2769-1790.
2.	So K, Kanatani KT, Kuroda Y, et al. Good short-term outcome of primary total hip arthroplasty with cementless bioactive glass ceramic bottom-coated implants. Acta Orthop, 2012, 83(6): 599-603.
3.	Yoo JJ, Yoon PW, Lee YK, et al. Revision Total Hip Arthroplasty Using an Alumina-On-Alumina Bearing Surface in Patients With Osteolysis. J Arthroplasty, 2013, 28(1): 132-138.
4.	Trumm BN, Callaghan JJ, Liu SS, et al. Revision with Cementless Acetabular Components: A Concise Follow-up, at a Minimum of Twenty Years, of Previous Reports. J Bone Joint Surg Am, 2012, 94(21): 2001-2004.
5.	Nourissat C, Essig J, Asencio G, et al. The Cementless Anatomic Benoist Girard (ABG) II Total Hip Arthroplasty: A Minimum 8-Year Follow-Up Study. J Arthroplasty, 2013, 28(4): 707-711.
6.	Mertl P, Combes A, Leiber-Wackenheim F, et al. Recurrence of dislocation following total hip arthroplasty revision using dual mobility cups was rare in 180 hips followed over 7 years. HSS J, 2012, 8(3): 251-256.
7.	Sariali E, Mouttet A, Mordasini P, et al. High 10-year survival rate with an anatomic cementless stem (SPS). Clin Orthop Relat Res, 2012, 470(7): 1941-1949.
8.	Massin P, Orain V, Philippot R, et al. Fixation failures of dual mobility cups: a mid-term study of 2601 hip replacements. Clin Orthop Relat Res, 2012, 470(7): 1932-1940.
9.	Pollard TC, Baker RP, Eastaugh-Waring SJ, et al. Treatment of the young active patient with osteoarthritis of the hip. A five- to seven-year comparison of hybrid total hip arthroplasty and metal-on-metal resurfacing. J Bone Joint Surg Br, 2006, 88(5): 592-600.
10.	Lingard EA, Muthumayandi K, Holland JP. Comparison of patient-reported outcomes between hip resurfacing and total hip replacement. J Bone Joint Surg Br, 2009, 91(12): 1550-1554.
11.	Vail TP, Mina CA, Yergler JD, et al. Metal-on-metal hip resurfacing compares favorably with THA at 2 years followup. Clin Orthop Relat Res, 2006, 453: 123-131.
12.	Klotz MC, Breusch SJ, Hassenpflug M, et al. Results of 5 to 10-year follow-up after hip resurfacing. A systematic analysis of the literature on long-term results. Orthopade, 2012, 41(6): 442-451.
13.	Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum, 1991, 34(5): 505-514.
14.	Girard J, Lavigne M, Vendittoli PA, et al. Biomechanical reconstruction of the hip a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg Br, 2006, 88(6): 721-726.
15.	Vendittoli PA, Lavigne M, Roy AG, et al. A prospective randomized clinical trial comparing metal‐on‐metal total hip arthroplasty and metal‐on‐metal total hip resurfacing in patients less than 65 years old. HIP Int, 2006, 16(Suppl 4): 73‐81.
16.	Girard J, Vendittoli PA, Roy AG, et al. Femoral offset restauration and clinical function after total hip arthroplasty and surface replacement of the hip: a randomized study. Rev Chir Orthop Reparatrice Appar Mot, 2008, 94(4): 376-381.
17.	Lavigne M, Masse V, Girard J, et al. Return to sport after hip resurfacing or total hip arthroplasty: a randomized study. Rev Chir Orthop Reparatrice Appar Mot, 2008, 94(4): 361-367.
18.	Rama KR, Vendittoli PA, Ganapathi M, et al. Heterotopic ossification after surface replacement arthroplasty and total hip arthroplasty: a randomized study. The Journal of Arthroplasty, 2009: 256‐262.
19.	Lavigne M, Therrien M, Nantel J, et al. The John Charnley Award: The functional outcome of hip resurfacing and large‐head THA is the same: a randomized, double‐blind study. Clinical orthopaedics and Related Research, 2010: 326‐336.
20.	Jensen C, Aagaard P, Overgaard S. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial. Osteoarthritis Cartilage, 2011, 19(9): 1108-1116.
21.	Smolders JM, Hol A, Rijnberg WJ, et al. "Metal ion levels and functional results after either resurfacing hip arthroplasty or conventional metal-on-metal hip arthroplasty. Acta Orthop, 2011, 82(5): 559-566.
22.	Petersen MK, Andersen NT, Mogensen P, et al. Gait analysis after total hip replacement with hip resurfacing implant or Mallory‐head Exeter prosthesis: a randomised controlled trial. Int Orthop, 2011, 35(5): 667‐674.
23.	Costa ML, Achten J, Parsons NR, et al. Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: single centre, parallel group, assessor blinded, randomised controlled trial. BMJ, 2012, 344: e2147.
24.	吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 203-207．.
25.	吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析. 中国循证医学杂志, 2005, 5(1): 51-58.
26.	Instructions for authors. Available from: http://jbjs.org/public/instructionsauthors.aspx.
27.	Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ, 2010, 340: c332.

1. Berry DJ. Primary total hip arthroplasty. In: Chapman MW, ed. Chapman’s Orthopaedic Surgery. Philadelphia: Lippincott Williams & Wilkins, 2001: 2769-1790.
2. So K, Kanatani KT, Kuroda Y, et al. Good short-term outcome of primary total hip arthroplasty with cementless bioactive glass ceramic bottom-coated implants. Acta Orthop, 2012, 83(6): 599-603.
3. Yoo JJ, Yoon PW, Lee YK, et al. Revision Total Hip Arthroplasty Using an Alumina-On-Alumina Bearing Surface in Patients With Osteolysis. J Arthroplasty, 2013, 28(1): 132-138.
4. Trumm BN, Callaghan JJ, Liu SS, et al. Revision with Cementless Acetabular Components: A Concise Follow-up, at a Minimum of Twenty Years, of Previous Reports. J Bone Joint Surg Am, 2012, 94(21): 2001-2004.
5. Nourissat C, Essig J, Asencio G, et al. The Cementless Anatomic Benoist Girard (ABG) II Total Hip Arthroplasty: A Minimum 8-Year Follow-Up Study. J Arthroplasty, 2013, 28(4): 707-711.
6. Mertl P, Combes A, Leiber-Wackenheim F, et al. Recurrence of dislocation following total hip arthroplasty revision using dual mobility cups was rare in 180 hips followed over 7 years. HSS J, 2012, 8(3): 251-256.
7. Sariali E, Mouttet A, Mordasini P, et al. High 10-year survival rate with an anatomic cementless stem (SPS). Clin Orthop Relat Res, 2012, 470(7): 1941-1949.
8. Massin P, Orain V, Philippot R, et al. Fixation failures of dual mobility cups: a mid-term study of 2601 hip replacements. Clin Orthop Relat Res, 2012, 470(7): 1932-1940.
9. Pollard TC, Baker RP, Eastaugh-Waring SJ, et al. Treatment of the young active patient with osteoarthritis of the hip. A five- to seven-year comparison of hybrid total hip arthroplasty and metal-on-metal resurfacing. J Bone Joint Surg Br, 2006, 88(5): 592-600.
10. Lingard EA, Muthumayandi K, Holland JP. Comparison of patient-reported outcomes between hip resurfacing and total hip replacement. J Bone Joint Surg Br, 2009, 91(12): 1550-1554.
11. Vail TP, Mina CA, Yergler JD, et al. Metal-on-metal hip resurfacing compares favorably with THA at 2 years followup. Clin Orthop Relat Res, 2006, 453: 123-131.
12. Klotz MC, Breusch SJ, Hassenpflug M, et al. Results of 5 to 10-year follow-up after hip resurfacing. A systematic analysis of the literature on long-term results. Orthopade, 2012, 41(6): 442-451.
13. Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum, 1991, 34(5): 505-514.
14. Girard J, Lavigne M, Vendittoli PA, et al. Biomechanical reconstruction of the hip a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg Br, 2006, 88(6): 721-726.
15. Vendittoli PA, Lavigne M, Roy AG, et al. A prospective randomized clinical trial comparing metal‐on‐metal total hip arthroplasty and metal‐on‐metal total hip resurfacing in patients less than 65 years old. HIP Int, 2006, 16(Suppl 4): 73‐81.
16. Girard J, Vendittoli PA, Roy AG, et al. Femoral offset restauration and clinical function after total hip arthroplasty and surface replacement of the hip: a randomized study. Rev Chir Orthop Reparatrice Appar Mot, 2008, 94(4): 376-381.
17. Lavigne M, Masse V, Girard J, et al. Return to sport after hip resurfacing or total hip arthroplasty: a randomized study. Rev Chir Orthop Reparatrice Appar Mot, 2008, 94(4): 361-367.
18. Rama KR, Vendittoli PA, Ganapathi M, et al. Heterotopic ossification after surface replacement arthroplasty and total hip arthroplasty: a randomized study. The Journal of Arthroplasty, 2009: 256‐262.
19. Lavigne M, Therrien M, Nantel J, et al. The John Charnley Award: The functional outcome of hip resurfacing and large‐head THA is the same: a randomized, double‐blind study. Clinical orthopaedics and Related Research, 2010: 326‐336.
20. Jensen C, Aagaard P, Overgaard S. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial. Osteoarthritis Cartilage, 2011, 19(9): 1108-1116.
21. Smolders JM, Hol A, Rijnberg WJ, et al. "Metal ion levels and functional results after either resurfacing hip arthroplasty or conventional metal-on-metal hip arthroplasty. Acta Orthop, 2011, 82(5): 559-566.
22. Petersen MK, Andersen NT, Mogensen P, et al. Gait analysis after total hip replacement with hip resurfacing implant or Mallory‐head Exeter prosthesis: a randomised controlled trial. Int Orthop, 2011, 35(5): 667‐674.
23. Costa ML, Achten J, Parsons NR, et al. Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: single centre, parallel group, assessor blinded, randomised controlled trial. BMJ, 2012, 344: e2147.
24. 吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 203-207．.
25. 吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析. 中国循证医学杂志, 2005, 5(1): 51-58.
26. Instructions for authors. Available from: http://jbjs.org/public/instructionsauthors.aspx.
27. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ, 2010, 340: c332.

《中国循证医学杂志》

全髋置换术与全髋表面置换术治疗骨关节炎的Meta分析

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《中国循证医学杂志》

全髋置换术与全髋表面置换术治疗骨关节炎的Meta分析

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