PDF(Pubmed)
Abstract：
Total hip arthroplasty (THA) is often regarded as one of the most successful surgical techniques developed in the twenty-first century. However, it is associated with complications such as prosthetic instability, dislocations, or infections. Dual-mobility (DM) implants have been developed with the goal of reducing the incidence of dislocations by increasing the femoral head-neck ratio, maximising hip stability, and improving the range of motion (ROM) before impingement and dislocation. This systematic review aims to comprehensively compare the safety and efficacy of DM versus fixed-bearing (FB) implants in primary THA patients. A comprehensive search strategy of PubMed, Embase, Scopus, and Web of Science Core Collection databases was executed to identify pertinent literature comparing DM and FB implants in THAs. Eligible studies underwent independent screening, and data were systematically extracted. The analysis employed pooled risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous variables, each accompanied by their respective 95% confidence intervals (CI). Our systematic review and meta-analysis included nine studies encompassing 22,277 patients. The DM group had a significantly reduced incidence of dislocations compared to the FB group (RR 0.25, 95%CI [0.13, 0.47]; p-value <0.0001) and a significantly shorter length of stay (MD -9.92, 95%CI [-15.53, -4.32]; p-value = 0.0005). The FB group, however, had a significantly shorter operative time compared to the DM group (MD 10.41, 95%CI [7.64, 13.17]; p-value < 0.00001). We did not identify any significant statistical differences between the DM and FB groups regarding patient-reported outcome measures, the incidence of all-cause readmissions, the incidence of peri-prosthetic fractures, the incidence of infections, or the incidence of groyne pain.
摘要：
全髋关节置换术（THA）通常被认为是二十一世纪开发的最成功的手术技术之一。然而,它与假体不稳定等并发症有关，位错,或感染。已经开发了双移动性（DM）植入物，其目的是通过增加股骨头颈比率来减少脱位的发生率。最大限度地提高髋关节稳定性，并改善撞击和位错前的运动范围（ROM）。本系统评价旨在全面比较DM与固定轴承（FB）植入物在原发性THA患者中的安全性和有效性。PubMed的全面搜索策略，Embase,Scopus,并执行了WebofScience核心收藏数据库，以确定比较THA中DM和FB植入物的相关文献。符合条件的研究进行了独立筛查，并系统地提取数据。分析采用二分结果的合并风险比(RR)和连续变量的平均差(MD)，每个人都有各自的95%置信区间(CI)。我们的系统评价和荟萃分析包括9项研究，包括22,277例患者。与FB组相比，DM组的脱位发生率明显降低（RR0.25,95CI[0.13,0.47]；p值<0.0001），住院时间明显缩短（MD-9.92,95CI[-15.53,-4.32]；p值=0.0005）。FB组,然而,与DM组相比,手术时间明显缩短(MD10.41,95CI[7.64,13.17];p值<0.00001).我们没有发现DM组和FB组之间关于患者报告的结局指标的任何显著统计学差异。全因再入院的发生率，假体周围骨折的发生率，感染的发生率，或腹股沟疼痛的发生率。
