Keurentjes JC, Pijls BG, Van Tol FR, Mentink JF, Mes SD, Schoones JW, Fiocco M, Sedrakyan A, Nelissen RG. Which implant should we use for primary total hip replacement? A systematic review and meta-analysis.
J Bone Joint Surg Am 2014;
96 Suppl 1:79-97. [PMID:
25520423 DOI:
10.2106/jbjs.n.00397]
[Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND
Many total hip implants are currently available on the market worldwide. We aimed to estimate the probability of revision surgery at ten years for each individual total hip implant and to compare these estimates with the National Institute for Health and Care Excellence (NICE) benchmark.
METHODS
We performed a meta-analysis of cohort studies. The methodological quality was assessed with use of the Assessment of Quality in Lower Limb Arthroplasty (AQUILA) checklist. We searched PubMed, Embase, Web of Science, and the Cochrane Library. Additionally, national joint registries that were full members of the International Society of Arthroplasty Registers (ISAR) were hand searched. Studies in which the authors reported the survival probability for either the acetabular or the femoral component of primary total hip replacements with use of revision for any reason or for aseptic loosening at ten years as the end point, with at least 100 implants at baseline, and in which at least 60% of the patients had primary osteoarthritis were eligible for inclusion.
RESULTS
The search strategy revealed 5513 papers describing survival probabilities for thirty-four types of acetabular components and thirty-two types of femoral components. Eight types of acetabular cups and fifteen types of femoral stems performed better than the NICE benchmark.
CONCLUSIONS
We recommend that surgeons performing a primary total hip replacement use an implant that outperforms the NICE benchmarks.
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