ARTHROPLASTY
Comparison of cemented and uncemented fixation in total hip replacement: a meta analysis
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):28 Acta Orthopaedica 2007; 78 (3): 315–326Use of cemented versus un-cemented implant fixation in total hip arthroplasty (THA) has long been an area of debate. Although cemented components have long had unsurpassed prosthesis survival rate, more and more THAs are being performed with un-cemented components. The current systematic review and meta analysis compared the pros and cons to cemented versus un-cemented fixation to determine which has a better overall performance. The study found that although the performance of un-cemented components is improving, cemented fixation continues to be unparalleled.
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Were the criteria used for deciding which studies to include in the overview reported?
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Were the criteria used for assessing the validity of the included studies reported?
Was the validity of all of the studies referred to in the text assessed with use of appropriate criteria (either in selecting the studies for inclusion or in analyzing the studies that were cited)?
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報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
3/4
Introduction
4/4
Accessing Data
4/4
Analysing Data
4/4
Results
3/4
Discussion
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Amidst the debate of cement versus un-cemented fixation, a clear answer on survivorship and rate of revisions has not been clearly established. A summary of evidence on how the type of fixation affects rate of survivorship is needed to determine which fixation is superior.
主な研究課題は何ですか？
In THA is survivorship superior with cemented or uncemented fixation?
重要な知見は？
- No overall superiority was demonstrated when failure was defined as revision of either or both components.
- Cemented fixation had favourable results at the population level but generalizability of this should be considered with caution due to sample differences.
- Further, cemented fixation was found to be inferior when titanium stems were used and superior when a stainless steel or cobalt chrome stem were used.
- Survivorship with un-cemented fixation improved overtime since 1995.
最も覚えておくべきことは？
The current literature suggests fixation with cement has superior survival rates when compared to un-cemented fixation although un-cemented fixation survivorship has improved over time.
それが私の患者ケアにどのように影響するか？
Although un-cemented fixation is improving, cemented fixation continues to outperform un-cemented fixation. However, more research with improved methods are needed to further determine the benefits of each method specific to various populations.
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