王裕民;

• 1:天津市天津医院

摘要(Abstract)：

[目的]系统评价骨水泥型与非骨水泥型假体全髋关节置换术后疗效。[方法]计算机检索(时间为1990~2013年12月)MEDLINE、EMBASE、Cochrane CENTRAL(Fourth Quarter 2013)、ScienceDirect、OVID、SpringerLink数据库。制定纳入和排除标准,筛选出符合纳入标准的文献,评价纳入研究的方法学质量。利用RevMan5.1.1(下载于Cochrane Library)进行Meta分析。[结果]经过筛选,10篇研究符合纳入标准,共1015例,其中骨水泥组496例,非骨水泥组519例。Meta分析结果显示:骨水泥组与非骨水泥组比较,前者术后5年内疼痛改善率优于后者,差异存在统计学意义(95%CI 1.62[0.41,2.83],P=0.009);术后翻修率、Harris评分、并发症和死亡率等方面两种假体组间差异无统计学意义(P值分别为0.17,0.68,0.53,0.94)。[结论]骨水泥型与非骨水泥型假体全髋关节置换在治疗股骨颈骨折及髋关节疾病中均取得了良好的疗效。骨水泥与非骨水泥型假体总体生存率及翻修率无明显差异,骨水泥型假体早期患者疼痛改善方面优于非骨水泥型假体,两组术后患者髋关节功能均达到满意效果,二者术后并发症及死亡率基本相同。

关键词(KeyWords)： 全髋关节置换术;骨水泥;非骨水泥;Meta分析

Abstract:

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基金项目(Foundation):

作者(Author): 王裕民;

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参考文献(References)：

• [1]Zeller V,Lhotellier L,Marmor S,et al.One-stage exchange arthroplasty for chronic periprosthetic hip infection:results of a large prospective cohort study[J].J Bone Joint Surg Am,2014,96(1):1.
• [2]Wykman A,Olsson E,Axdorph G,et al.Total hip arthroplasty.A comparison between cemented and press-fit noncemented fixation[J].J Arthroplasty,1991,6(1):19-29.
• [3]Godsiff SP,Emery RJ,Heywood-Waddington MB,et al.Cemented versus uncemented femoral components in the ring hip prosthesis[J].J Bone Joint Surg Br,1992,74(6):822-824.
• [4]Reigstad A,Rokkum M,Bye K,et al.Femoral remodeling after arthroplasty of the hip.Prospective randomized 5-year comparison of120 cemented/uncemented cases of arthrosis[J].Acta Orthop Scand,1993,64(4):411-416.
• [5]Onsten I,Carlsson AS.Cemented versus uncemented socket in hip arthroplasty.A radiostereometric study of 60 randomized hips followed for 2 years[J].Acta Orthop Scand,1994,65(5):517-521.
• [6]Karrholm J,Malchau H,Snorrason F,et al.Micromotion of femoral stems in total hip arthroplasty.A randomized study of cemented,hydroxyapatite-coated,and porous-coated stems with roentgen stereophotogrammetric analysis[J].J Bone Joint Surg Am,1994,76(11):1692-1705.
• [7]Laupacis A,Bourne R,Rorabeck C,et al.Comparison of total hip arthroplasty performed with and without cement:a randomized trial[J].J Bone Joint Surg Am,2002,84(10):1823-1828.
• [8]Guerra E,Traina F,Antonietti B,et al.Cemented versus cementless stem-to-bone fixation:a long-term survival comparison[J].Chir Organi Mov,2003,88(3):253-255.
• [9]Mc Combe P,Williams SA.A comparison of polyethylene wear rates between cemented and cementless cups.A prospective,randomised trial[J].J Bone Joint Surg Br,2004,86(3):344-349.
• [10]Grant P,Aamodt A,Falch JA,et al.Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem.A randomized study with use of radiostereometry and bone densitometry[J].J Orthop Res,2005,23(6):1280-1285.
• [11]Strom H,Kolstad K,Mallmin H,et al.Comparison of the uncemented cone and the cemented bimetric hip prosthesis in young patients with osteoarthritis:an RSA,clinical and radiographic study[J].Acta Orthop,2006,77(1):71-78.
• [12]Charnley J.The long-term results of low-friction arthroplasty of the hip performed as a primary intervention.1970[J].Clin Orthop,2005,430(430):3-11.
• [13]Bolognesi MP,Pietrobon R,Clifford PE,et al.Comparison of a hydroxyapatite-coated sleeve and a porous-coated sleeve with a modular revision hip stem.A prospective,randomized study[J].J Bone Joint Surg Am,2004,86-A(12):2720-2725.
• [14]Talsnes O,Vinje T,Gjertsen JE,et al.Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis:a register study of 11,210 patients[J].Int Orthop,2013,37(6):1135-1140.
• [15]赵洪普,徐秋玉,吕玉明,等.骨水泥型与非骨水泥型双动人工股骨头治疗老年股骨颈骨折的对比研究[J].中国矫形外科杂志,2012,20(12):1099-1101.
• [16]Weiss RJ,Hailer NP,Stark A,et al.Survival of uncemented acetabular monoblock cups:evaluation of 210 hips in the swedish hip arthroplasty register[J].Acta Orthop,2012,83(3):214-219.
• [17]高玉镭,田敏,王东辰,等.骨水泥和非骨水泥型人工股骨双动头置换的临床疗效分析[J].中国矫形外科杂志,2013,21(6):571-574.
• [18]Havelin LI,Engesaeter LB,Espehaug B,et al.The Norwegian Arthroplasty Register:11 years and 73 000 arthroplasties[J].Acta Orthop Scand,2000,71(4):337-353.
• [19]Lucht U.The Danish Hip Arthroplasty Register[J].Acta Orthop Scand,2000,71(5):433-439.
• [20]Hailer NP,Garellick G,Karrholm J.Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register[J].Acta Orthop,2010,81(1):34-41.
• [21]Eskelinen A,Remes V,Helenius I,et al.Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish Arthroplasty Register.4,661 primary replacements followed for 0-22 years[J].Acta Orthop,2005,76(1):28-41.
• [22]Hooper GJ,Rothwell AG,Stringer M,et al.Revision following cemented and uncemented primary total hip replacement:a seven-year analysis from the New Zealand Joint Registry[J].J Bone Joint Surg Br,2009,91(4):451-458.