The Choice of Hip Arthroplasty: HRA or THA? Revealed by Meta-Analysis.

IF 1.8 2区 医学 Q2 ORTHOPEDICS Orthopaedic Surgery Pub Date : 2025-03-16 DOI:10.1111/os.70019
Xiao Fan, Yimin Zhou, Tianyu Zhou, Justin P Cobb, Tengbo Yu
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Abstract

Background: Total hip arthroplasty (THA) is the gold standard for end-stage hip arthrosis, while hip resurfacing arthroplasty (HRA) is considered a more bone-conserving alternative. This meta-analysis aimed to compare the safety and clinical efficacy of HRA and THA.

Methods: The databases of PubMed, EMBASE, Cochrane Library, and CNKI were searched for RCTs comparing HRA and THA in treating hip arthrosis from database initiation to April 2024. Inclusion and exclusion criteria were defined, and data extraction, quality evaluation, and risk bias assessment were performed. A meta-analysis was conducted using appropriate RevManv5.4 and Stata v14.0 software.

Results: Twenty RCTs from six countries were included. HRA had a similar revision rate, function scores (WOMAC, HSS, OHS, UCLA activity score, EQ-D, EQ-5D VAS), and blood levels of cobalt and chromium compared to THA. HRA had fewer complications and less blood loss but required more operating time.

Conclusions: HRA is a safe and effective alternative to THA, with similar revision and functional outcomes, less blood loss, and is particularly suitable for young male patients with a demand for high-level activities.

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背景:全髋关节置换术(THA)是治疗终末期髋关节病的金标准,而髋关节置换术(HRA)被认为是一种更能保护骨质的替代方案。这项荟萃分析旨在比较 HRA 和 THA 的安全性和临床疗效:方法:在 PubMed、EMBASE、Cochrane Library 和 CNKI 等数据库中检索了自数据库启动至 2024 年 4 月期间比较 HRA 和 THA 治疗髋关节病的 RCT。界定了纳入和排除标准,并进行了数据提取、质量评估和风险偏倚评估。使用RevManv5.4和Stata v14.0软件进行了荟萃分析:结果:纳入了来自 6 个国家的 20 项研究。与 THA 相比,HRA 的翻修率、功能评分(WOMAC、HSS、OHS、UCLA 活动评分、EQ-D、EQ-5D VAS)以及血液中的钴和铬含量相似。HRA的并发症更少,失血更少,但需要更多的手术时间:结论:HRA是THA的一种安全有效的替代方案,具有相似的翻修和功能效果,失血量较少,尤其适合有高水平活动需求的年轻男性患者。
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来源期刊
Orthopaedic Surgery
Orthopaedic Surgery ORTHOPEDICS-
CiteScore
3.40
自引率
14.30%
发文量
374
审稿时长
20 weeks
期刊介绍: Orthopaedic Surgery (OS) is the official journal of the Chinese Orthopaedic Association, focusing on all aspects of orthopaedic technique and surgery. The journal publishes peer-reviewed articles in the following categories: Original Articles, Clinical Articles, Review Articles, Guidelines, Editorials, Commentaries, Surgical Techniques, Case Reports and Meeting Reports.
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