Abstract：
BACKGROUND: Acetabular erosion is an important complication in hemiarthroplasty and may lead to total hip arthroplasty as a conversion. The results of total hip arthroplasty as a conversion remain unclear. We performed a systematic review and meta-analysis to compare the outcome of total hip arthroplasty as a conversion with primary total hip arthroplasty.
METHODS: PRISMA guidelines were used and Pubmed, Embase and the Cochrane libraries were searched. Both, studies comparing the outcome of total hip arthroplasty as a conversion with the outcome of primary total hip arthroplasty and the outcome of cohort studies limited to total hip arthroplasty as a conversion, were included. Risk of bias was assessed using the Methodological Index for Non Randomized Studies checklist. Meta-analysis was performed concerning pooled annual revision, dislocation and infection rates.
RESULTS: A total of 27 studies were available for analysis; four comparative studies and 23 cohort studies. Comparative studies were defined as high quality and cohort studies as medium quality. Analysis revealed a significantly higher overall revision risk (Hazard Ratio 1.72, 95% confidence interval 1.39 to 2.14) after total hip arthroplasty as a conversion compared to primary total hip arthroplasty. The annual revision rate of total hip arthroplasty as a conversion was 1.63% (95% confidence interval 1.14 to 2.33) in the comparative studies and 1.40% (95% confidence interval 1.17 to 1.66) in the cohort studies. A pooled infection rate of 4.34% (95% confidence interval 2.66 to 7.01) and dislocation rate of 4.79% (95% confidence interval 3.02 to 7.53), was found.
CONCLUSIONS: Literature concerning the results of total hip arthroplasty as a conversion is limited. The risk of revision after conversion of hemiarthroplasty is higher compared to primary total hip arthroplasty.
METHODS: PRISMA guidelines were used and Pubmed, Embase and the Cochrane libraries were searched. Both, studies comparing the outcome of total hip arthroplasty as a conversion with the outcome of primary total hip arthroplasty and the outcome of cohort studies limited to total hip arthroplasty as a conversion, were included. Risk of bias was assessed using the Methodological Index for Non Randomized Studies checklist. Meta-analysis was performed concerning pooled annual revision, dislocation and infection rates.
RESULTS: A total of 27 studies were available for analysis; four comparative studies and 23 cohort studies. Comparative studies were defined as high quality and cohort studies as medium quality. Analysis revealed a significantly higher overall revision risk (Hazard Ratio 1.72, 95% confidence interval 1.39 to 2.14) after total hip arthroplasty as a conversion compared to primary total hip arthroplasty. The annual revision rate of total hip arthroplasty as a conversion was 1.63% (95% confidence interval 1.14 to 2.33) in the comparative studies and 1.40% (95% confidence interval 1.17 to 1.66) in the cohort studies. A pooled infection rate of 4.34% (95% confidence interval 2.66 to 7.01) and dislocation rate of 4.79% (95% confidence interval 3.02 to 7.53), was found.
CONCLUSIONS: Literature concerning the results of total hip arthroplasty as a conversion is limited. The risk of revision after conversion of hemiarthroplasty is higher compared to primary total hip arthroplasty.
摘要：
背景：髋臼侵蚀是半髋关节置换术的重要并发症，可能导致全髋关节置换术的转换。全髋关节置换术作为转换的结果尚不清楚。我们进行了系统评价和荟萃分析，以比较全髋关节置换术作为转换的结果与初次全髋关节置换术的结果。
方法：使用PRISMA指南并发布，搜索Embase和Cochrane库。两者,比较全髋关节置换术作为转换的结果与初次全髋关节置换术的结果以及限于全髋关节置换术作为转换的队列研究的结果的研究，包括在内。使用非随机研究方法学指数检查表评估偏倚风险。进行了关于汇总年度修订的荟萃分析，脱位和感染率。
结果：共有27项研究可供分析；4项比较研究和23项队列研究。比较研究定义为高质量，队列研究定义为中等质量。分析显示，与初次全髋关节置换术相比，全髋关节置换术后的总翻修风险（危险比1.72，95％置信区间1.39至2.14）明显更高。在比较研究中，全髋关节置换术作为转换的年翻修率为1.63%（95%置信区间1.14至2.33），在队列研究中为1.40%（95%置信区间1.17至1.66）。合并感染率为4.34％（95％置信区间为2.66至7.01），脱位率为4.79％（95％置信区间为3.02至7.53），找到了。
结论：关于全髋关节置换术作为转换的结果的文献有限。与初次全髋关节置换术相比，半髋关节置换术转换后翻修的风险更高。
方法：使用PRISMA指南并发布，搜索Embase和Cochrane库。两者,比较全髋关节置换术作为转换的结果与初次全髋关节置换术的结果以及限于全髋关节置换术作为转换的队列研究的结果的研究，包括在内。使用非随机研究方法学指数检查表评估偏倚风险。进行了关于汇总年度修订的荟萃分析，脱位和感染率。
结果：共有27项研究可供分析；4项比较研究和23项队列研究。比较研究定义为高质量，队列研究定义为中等质量。分析显示，与初次全髋关节置换术相比，全髋关节置换术后的总翻修风险（危险比1.72，95％置信区间1.39至2.14）明显更高。在比较研究中，全髋关节置换术作为转换的年翻修率为1.63%（95%置信区间1.14至2.33），在队列研究中为1.40%（95%置信区间1.17至1.66）。合并感染率为4.34％（95％置信区间为2.66至7.01），脱位率为4.79％（95％置信区间为3.02至7.53），找到了。
结论：关于全髋关节置换术作为转换的结果的文献有限。与初次全髋关节置换术相比，半髋关节置换术转换后翻修的风险更高。
