Elbardesy H, Anazor F, Mirza M, Aly M, Maatough A. Cemented versus uncemented stems for revision total hip replacement: A systematic review and meta-analysis. World J Orthop 2023; 14(8): 630-640 [PMID: 37662666 DOI: 10.5312/wjo.v14.i8.630]
Corresponding Author of This Article
Hany Elbardesy, FRSC, MBChB, MD, MSc, PhD, Doctor, Postdoctoral Fellow, Department of Trauma and Orthopaedics, University of Manitoba, Sherbrook St, Winnipeg MB R3T2N2, Manitoba, Canada. elbardeh@myumanitoba.ca
Research Domain of This Article
Orthopedics
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2023; 14(8): 630-640 Published online Aug 18, 2023. doi: 10.5312/wjo.v14.i8.630
Cemented versus uncemented stems for revision total hip replacement: A systematic review and meta-analysis
Hany Elbardesy, Fitzgerald Anazor, Mohammad Mirza, Mohamed Aly, Annis Maatough
Hany Elbardesy, Department of Trauma and Orthopaedics, University of Manitoba, Winnipeg MB R3T2N2, Manitoba, Canada
Fitzgerald Anazor, Nottingham University Hospitals NHS Foundation Trust, Nottingham NG7 2UH, United Kingdom
Mohammad Mirza, Annis Maatough, Department of Trauma and Orthopaedics, East Kent University Hospitals NHS Foundation Trust, Ashford TN240LY, Kent, United Kingdom
Mohamed Aly, Department of Trauma and Orthopaedics, Royal National Orthopaedic Hospital, London HA7 4LP, United Kingdom
Author contributions: Elbardesy H and Anazor F involved in the conceptualization of the study and data interpretation; Elbardesy H, Anazor F, and Mirza M contributed to the data analysis; Elbardesy H, Anazor F, and Aly M contributed to the study design; Elbardesy H, Anazor F, and Maatough A involved in the selection and screening of studies; Elbardesy H, Anazor F, Mirza M, Aly M, and Maatough A contributed to the manuscript preparation-writing and editing; and all authors read and approved the final draft of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hany Elbardesy, FRSC, MBChB, MD, MSc, PhD, Doctor, Postdoctoral Fellow, Department of Trauma and Orthopaedics, University of Manitoba, Sherbrook St, Winnipeg MB R3T2N2, Manitoba, Canada. elbardeh@myumanitoba.ca
Received: March 4, 2023 Peer-review started: March 4, 2023 First decision: June 14, 2023 Revised: June 20, 2023 Accepted: July 17, 2023 Article in press: July 17, 2023 Published online: August 18, 2023 Processing time: 165 Days and 13 Hours
ARTICLE HIGHLIGHTS
Research background
There is no published systematic review and meta-analysis looking at the research question in this study, despite the large number of revision total hip arthroplasties (THA) performed worldwide.
Research motivation
We have had this nagging question: “Is there any scientific evidence from published studies that shows a difference in outcomes between the cemented and uncemented stems, for revision total hip arthroplasty?”
Research objectives
To assess the outcomes (intraoperative periprosthetic fractures, aseptic loosening, dislocation and infection rates) of both cemented and uncemented stems after mid-term follow up.
Research methods
A meta-analysis of non-randomized interventional studies.
Research results
This paper included a meta-analysis of three studies involving 7600 revision total hip replacements, of which 3050 were performed using cemented stems, while 2539 were performed utilising uncemented stems. There were no statistically significant differences found for intraoperative periprosthetic fractures [risk ratios (RRs) = 1.25; 95% confidence interval (CI): 0.29-5.32; P = 0.76], aseptic loosening (RR = 2.15, 95%CI: 0.81-5.70; P = 0.13), dislocation rate (RR = 0.50; 95%CI: 0.10-2.47; P = 0.39), or infection rate (RR = 0.99, 95%CI: 0.82-1.19; P = 0.89), between the uncemented and the cemented long stems for revision THA after mid-term follow-up.
Research conclusions
Low-moderate quality evidence showing no statistically significant differences between the cemented and uncemented stems for revision THA.
Research perspectives
We believe the evidence from this study should be interpreted with caution, due to the lack of any randomized controlled study being eligible for inclusion in the meta-analysis. Furthermore, significant heterogeneity was found between the included studies.
