No adverse effects seen with early full weight bearing after total hip arthroplasty .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):95 Acta Orthop. 2007 Dec;78(6):730-843 patients undergoing uncemented total hip arthroplasty (THA) with hydroxyapatite coating and anteverted stem were randomized to undergo one of two procedures postoperatively. The first group participated in early full weight bearing while the second group participated in early partial weight bearing. The primary outcomes were migration of the stem and cup, as well as the penetration of the femoral head. Results at the 3-month follow-up indicated there were no adverse effects on early full weight bearing after THA.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Oui = 1
Incertain = 0,5
Non pertinent = 0
Non = 0
L'évaluation des critères de rapport permet d'évaluer la transparence avec laquelle les auteurs rapportent les caractéristiques méthodologiques et les caractéristiques de l'essai dans la publication. L'évaluation est divisée en cinq catégories qui sont présentées ci-dessous.
4/4
Randomization
3/4
Outcome Measurements
2/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'indice de fragilité est un outil qui aide à l'interprétation des résultats significatifs, en fournissant une mesure de la force d'un résultat. L'indice de fragilité représente le nombre d'événements consécutifs qui doivent être ajoutés à un résultat dichotomique pour que le résultat ne soit plus significatif. Un petit nombre représente un résultat plus faible et un grand nombre un résultat plus fort.
Pourquoi cette étude était-elle nécessaire maintenant ?
Early weight bearing is often recommended and administered following total hip arthroplasty (THA), but there is still a lack of evidence to support this procedure. Some recent studies have examined clinical results in early weight bearing but there have yet to be any studies where analysis is performed using radiostereometry. This study examines the outcomes of early full and partial weight bearing after THA using radiostereometry to assess migration of the stem and cup as well as penetration of the femoral head.
Quelle était la principale question de recherche ?
What are the outcomes of early full and partial weight bearing after uncemented total hip arthroplasty on migration of the stem and cup, as well as the penetration of the femoral head in patients with hip osteoarthritis at 3 months?
- The partial weight bearing group (control) had a mean proximal (+)/ distal (-) migration of the stem of -0.14 mm (-1.93-0.11) at 3 months compared to the full weight bearing group (intervention) which had a migration of -0.31 mm (-4.30-0.16). (p=0.6)
- The mean migration at the 1-year follow-up was -0.17 mm (-2.18-0.21) for the partial weight bearing group and -0.28 mm (-4.31-0.11) for the full weight bearing group. (p=0.9)
- No significant differences were seen in stem rotations between the two groups. (p>0.2)
- Both groups had similar cup translations, rotations, and femoral head penetration. (p>0.1)
De quoi dois-je me souvenir en priorité ?
Full weight bearing immediately after uncemented total hip arthroplasty (THA) is justified under the conditions of this study. No adverse effects were seen in patients undergoing the early full weight bearing procedure initially and up to the 1-year follow-up after THA.
Comment cela affectera-t-il les soins prodigués à mes patients ?
Full weight bearing after THA is a justifiable option for postoperative management in patients based on the findings of this study. However, further trials are required to assess if early weight bearing provides clinically significant improvements in functional outcomes for patients undergoing THA.
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