■全髋关节置换术是治疗骨关节炎的可靠选择。它减轻了疼痛,提高生活质量,并恢复功能。直接前路(DAA),后路(PA),和直的横向方法(SLA)大多使用。这篇系统的综述评估了当前关于DAA成本和成本效益的文献,PA,和SLA。
■系统评论和荟萃分析(PRISMA)系统搜索的首选报告项目,在PROSPERO数据库中注册(注册号:CRD42021237427),是对PubMed数据库进行的,CINAHL,EMBASE,科克伦,临床试验,电流控制试验,ClinicalTrials.gov,NHS审查和传播中心,Econlit,和WebofScience。符合条件的研究是随机对照试验(RCT)或比较队列研究,报告或比较两种方法的成本或成本效益作为主要结局。评估偏倚风险(RoB)。为了比较,所有费用均转换为美元(2016年参考年)。
■纳入了6项系统评价研究。RoB从低到高,证据水平为2~4,方法学质量中等.DAA的费用从5313.85美元到15859.00美元(直接)和1921.00美元到6364.30美元(间接)不等。PA从$5158.46到$12344.47(直接)到$2265.70到$5566.01(间接),SLA从$3265.62到$8501.81(直接)和$2280.16(间接)。由于包含成本的异质性,它们没有直接可比性。无法提供有关成本效益的可靠数据。
■由于关于成本和成本效益的证据有限且异质,这些手术方法的效果尚不清楚.需要进一步进行有力的研究以得出无可争议的结论。
UNASSIGNED: Total hip arthroplasty is a reliable option to treat osteoarthritis. It reduces pain, increases quality of life, and restores function. The direct anterior approach (DAA), posterior approach (PA), and straight lateral approach (SLA) are mostly used. This systematic
review evaluates current literature about costs and cost-effectiveness of DAA, PA, and SLA.
UNASSIGNED: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic search, registered in the PROSPERO database (registration number: CRD42021237427), was conducted of databases PubMed, CINAHL, EMBASE, Cochrane, Clinical Trials, Current Controlled Trials, ClinicalTrials.gov, NHS Centre for
Review and Dissemination, Econlit, and Web of Science. Eligible studies were randomized controlled trials (RCTs) or comparative cohort studies reporting or comparing costs or cost-effectiveness of either approach as the primary outcome. The risk of bias (RoB) was assessed. For comparison, all costs were converted to American Dollars (reference year 2016).
UNASSIGNED: Six systematic
review studies were included. RoB ranged from low to high, the level of evidence ranged from 2 to 4, and methodological quality was moderate. Costs ranged from $5313.85 to $15 859.00 (direct) and $1921.00 to $6364.30 (indirect) in DAA. From $5158.46 to $12 344.47 (direct) to $2265.70 to $5566.01 (indirect) for PA and from $3265.62 to $8501.81 (direct) and $2280.16 (indirect) for SLA. Due to heterogeneity of included costs, they were not directly comparable. Solid data about cost-effectiveness cannot be presented.
UNASSIGNED: Due to limited and heterogenous evidence about costs and cost-effectiveness, the effect of these in surgical approach is unknown. Further well-powered research to make undisputed conclusions is needed.