Are short-stem prostheses superior to conventional stem prostheses in primary total hip arthroplasty? A systematic review and meta-analysis of randomised controlled trials

ObjectiveCementless total hip arthroplasty (THA) is associated with reliable clinical results and high patient satisfaction. Short-stem prostheses (SS) were designed to achieve superior preservation of proximal bone stock and stability compared with those of conventional-stem prostheses (CS). This m...

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Bibliographic Details
Published in:BMJ open 2018-09, Vol.8 (9), p.e021649-e021649
Main Authors: Liang, Hao-Dong, Yang, Wei-Yi, Pan, Jian-Ke, Huang, He-Tao, Luo, Ming-Hui, Zeng, Ling-Feng, Liu, Jun
Format: Article
Language:English
Subjects:
Arthritis
Bone density
Clinical outcomes
Clinical trials
Collaboration
Joint replacement surgery
Joint surgery
Meta-analysis
Patient satisfaction
Prostheses
Surgery
Systematic review
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Summary:ObjectiveCementless total hip arthroplasty (THA) is associated with reliable clinical results and high patient satisfaction. Short-stem prostheses (SS) were designed to achieve superior preservation of proximal bone stock and stability compared with those of conventional-stem prostheses (CS). This meta-analysis was conducted to determine the proximal bone remodelling, revision rate, Harris Hip Score, radiolucent line and maximum total point motion values of both SS and CS for primary THA.MethodRelevant randomised controlled trials (RCTs) involving SS and CS in primary THA were identified from electronic databases, such as EMBASE, PubMed and the Cochrane Library.ResultUltimately, 12 RCTs involving 1130 patients (1387 hips) were included. The results showed that compared with CS, SS resulted in less bone mineral density (BMD) changes in Gruen zone 7 at 1 year and 2 years postoperatively (mean difference (MD)=5.11; 95% CI, 1.61, 8.61; P=0.30; and MD=4.90; 95% CI, 1.01, 8.79; P=0.17, respectively). No difference in BMD changes was found for Gruen zone 1 (MD=2.66; 95% CI, −3.31, 8.64; P
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-021649