Cementirana naspram necementirana hemiartroplastika za pomaknute frakture vrata bedrene kosti: meta-analiza randomiziranih kontroliranih tragova.
Medicine
Sažetak istraživanja
Pozadina
Svrha ove meta-analize bila je da se uporedi efikasnost i bezbednost cementirane i necementirane hemiartroplastike kod pomerenih preloma vrata femura.
Metode Pretraživali smo PUBMED, EMBASE, Cochrane biblioteku i Google Scholar od njihovog početka do februara 2016. Svi RCT-ovi koji su upoređivali cementiranu sa necementiranom hemiartroplastikom za pomaknute frakture vrata bedrene kosti bili su podobni. Sudionici koji su podvrgnuti primarnoj hemiartroplastici zbog jednostranog prijeloma vrata bedrene kosti bili su stariji od 55 godina i prosječna starost veća od 75 godina. Za pokuse prije 2006. godine korištene su staro dizajnirane proteze, tako da smo isključili staze prije 2006. godine koje su koristile staro dizajnirane proteze. Ishodi od interesa uključuju postoperativnu funkciju kuka, Harrisov rezultat kuka (HHS), mortalitet, stopu reoperacije, komplikacije, vrijeme operacije, intraoperativni gubitak krvi. Dva recenzenta su nezavisno procenila uključene studije i izdvojila podatke u RevMan. Procjene kvaliteta su klasifikovane dogovorom 2 autora na osnovu Cochrane alata.
Rezultati Sedam studija je bilo prihvatljivo. Postoperativna funkcija kuka nakon 12 mjeseci cementirane hemiartroplastike bila je bolja od one kod necementirane hemiartroplastike (OR = 0,52, 95% CI, 0,31-0,88; P = ,01). Stope postoperativnih prijeloma kod cementirane hemiartroplastike bile su niže nego kod necementirane hemiartroplastike (OR = 0,09, 95% CI, 0,02-0,38; P = 0,001). Također, interoperativne stope prijeloma kod cementirane hemiartroplastike bile su niže nego kod necementirane hemiartroplastike (OR = 0,29, 95% CI, 0,13-0,68; P = 0,004). Kraće operacijsko vrijeme postignuto je kod necementirane hemiartroplastike nego kod cementirane hemiartroplastike (WMD = 8,22 min, 95% CI, 5,57-10,86 min; P
Zaključak Dostupni dokazi ukazuju na to da je u usporedbi s necementiranom hemiartroplastikom cementirana hemiartroplastika, manja postoperativna interplasirana frakcija kuka postigla bolju postoperativnu funkciju frakcije kuka Prijelom vrata femura postigao je kraće vrijeme operacije.
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Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A meta-analysis of randomized controlled trails.
Background The purpose of this meta-analysis was to compare the effectiveness and safety of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures.
Methods We searched PUBMED, EMBASE, Cochrane Library, and Google Scholar from their inception to February 2016. All RCTs comparing cemented with uncemented hemiarthroplasty for displaced femoral neck fractures were eligible. The participants who underwent primary hemiarthroplasty for unilateral femoral neck fracture were older than 55 and the mean age of more than 75 years old. For the trials before 2006 used old designed prostheses, so we excluded trails before 2006 which used old designed prostheses. Outcomes of interest include postoperative hip function, Harris hip score (HHS), mortality, reoperation rate, complications, operation time, intraoperative blood loss. Two reviewers independently evaluated the included studies and extracted data into RevMan. Quality Assessments were classified by agreement of 2 authors based on the Cochrane tool.
Results Seven trials were eligible. Postoperative hip function at 12 months cemented hemiarthroplasty was better than that in uncemented hemiarthroplasty (OR = 0.52, 95% CI, 0.31-0.88; P = .01). Postoperative fractures rates in cemented hemiarthroplasty were lower than that in uncemented hemiarthroplasty (OR = 0.09, 95% CI, 0.02-0.38; P = .001). Also, the interoperative fracture rates in cemented hemiarthroplasty were lower than that in uncemented hemiarthroplasty (OR = 0.29, 95% CI, 0.13-0.68; P = .004). Shorter operation time was achieved in uncemented hemiarthroplasty than that in cemented hemiarthroplasty (WMD = 8.22 min, 95% CI, 5.57-10.86 min; P
Conclusion The available evidence indicates that compared with uncemented hemiarthroplasty cemented hemiarthroplasty achieved better postoperative hip function, less postoperative, and interoperative fractures in displaced femoral neck fracture. Uncemented hemiarthroplasty achieved shorter operation time. There was no difference between the 2 groups with HHS at 1 year, mortality, and complications.
Izvorni podaci
- DOI
- 10.1097/md.0000000000014634
- PMID
- 30813202
- PMCID
- PMC6407990
- Provjereno
- 2026-07-26
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