Total hip replacement: A meta-analysis to evaluate survival of cemented, cementless and hybrid implants

Table 3 Summary of finding table comparing cemented to hybrid total hip replacement

Outcomes	Illustrative comparative risks6 (95%CI)		Relative effect(95%CI)	No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Hybrid	Cemented
Revision of any component due to any reason - RCT Follow-up: 6.5 to 14 yr	Study population		RR 0.73 (0.47 to 1.13)	402 (2 studies)	+--- very low1,2,3
	187 per 1000	136 per 1000 (88 to 211)
	Moderate
	177 per 1000	129 per 1000 (83 to 200)
Revision of any component due to any reason - Register or Cohort of register Follow-up: 4 to 7 yr	Study population		RR 0.82 (0.76 to 0.89)	76746 (3 studies)	+--- very low3,4
	30 per 1000	24 per 1000 (23 to 26)
	Moderate
	31 per 1000	25 per 1000 (24 to 28)
Revision of any component due to any reason - All types of study Follow-up: 4 to 15.4 yr	Study population		RR 0.82 (0.76 to 0.89)	77265 (6 studies)	+--- very low3,5
	31 per 1000	25 per 1000 (23 to 27)
	Moderate
	104 per 1000	85 per 1000 (79 to 93)
Revision of any component due to aseptic loosening - All types of study Follow-up: 6.5 to 15.4 yr	Study population		RR 2.65 (1.14 to 6.17)	519 (3 studies)	+--- very low3,5
	23 per 1000	62 per 1000 (27 to 145)
	Moderate
	0 per 1000	0 per 1000 (0 to 0)
Revision of any component due to infection - Register or Cohort of register Follow-up: 0 to 14 yr	Study population		Not estimable	86389 (2 studies)	+--- very low3,4
	7 per 1000	0 per 1000 (0 to 0)
	Moderate
Revision of any component due to infection - All types of study Follow-up: 0 to 14 yr	Study population		RR 0.98	86881	+---
	7 per 1000	7 per 1000 (5 to 10)	(0.7 to 1.38)	(5 studies)	very low1,2,3,5
	Moderate
	2 per 1000	2 per 1000 (1 to 3)
Dislocation of any component - Register of Cohort of register Follow-up: 5 to 7 yr	Study population		RR 0.68 (0.57 to 0.8)	60584 (2 studies)	+--- very low3,4
	11 per 1000	7 per 1000 (6 to 9)
	Moderate
	11 per 1000	7 per 1000 (6 to 9)
Dislocation of any component - All types of study Follow-up: 5 to 14 yr	Study population		RR 0.67 (0.57 to 0.79)	60824 (3 studies)	+--- very low3,5
	11 per 1000	7 per 1000 (6 to 9)
	Moderate
	14 per 1000	9 per 1000 (8 to 11)

CI: Confidence interval; RR: Risk ratio; GRADE Working Group grades of evidence; High quality: Further research is very unlikely to change our confidence in the estimate of effect; moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; very low quality: We are very uncertain about the estimate.

¹95% confidence interval around the pooled or best estimate of effect includes both (1) no effect and (2) appreciable benefit or appreciable harm (> 25%);

²No explanation was provided;

³Unexplained heterogeneity;

⁴Indirect studies from registers;

⁵Overall result from all types of study;

⁶The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95%CI).