Published online Aug 18, 2023. doi: 10.5312/wjo.v14.i8.630
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
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.
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?”
To assess the outcomes (intraoperative periprosthetic fractures, aseptic loosening, dislocation and infection rates) of both cemented and uncemented stems after mid-term follow up.
A meta-analysis of non-randomized interventional studies.
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.
Low-moderate quality evidence showing no statistically significant differences between the cemented and uncemented stems for revision THA.
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.