A Meta-Analysis to Evaluate Implant Survival and Benefits of the Use of Dual Mobility Constructs in Total Hip Replacement Following Hip Fracture.
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Authors
Macdonald, Hamish
Gardner, Andrew
Sayers, Adrian
Evans, Jon
Whitehouse, Michael R
Issue Date
2024-04-22
Type
Journal Article
Review
Review
Language
en
Keywords
Wessex Classification Subject Headings::Orthopaedics
Alternative Title
Abstract
Total hip replacement (THR) is commonly performed to treat hip fractures. Dual-mobility constructs (DMCs) are increasingly used for this indication. The aim of this study was to use evidence synthesis techniques to estimate net all-cause construct survival for THR with DMC performed for hip fracture. Additionally, we aimed to investigate and describe differences in all-cause construct survival (if present) between THRs performed with DMC (DMC-THR) or with a conventional bearing construct following hip fracture. We performed a systematic review and meta-analysis of published studies (including joint registries), including DMC-THR for hip fracture which provided Kaplan-Meier (KM) survival estimates. The primary outcome was all-cause construct survival over time. The study was prospectively registered on PROSPERO (CRD42020173117). A total of 557 papers and 17 registry reports were identified. Six studies (four registry reports, one matched-pair cohort study utilising joint registry data, and one single-institution case series) met the inclusion criteria, including 17,370 DMC THRs and 167,377 conventional THRs. Five-year KM survival estimates (95% confidence intervals) were similar at 95.4% (94.9 to 95.8%) for DMC-THR and 96.2% (96.0 to 96.4%) for conventional THR. The relative risk of revision for DMC-THR at five years was 1.21 (1.05 to 1.41). These results suggest that DMC-THR has a lower all-cause survival than conventional THR following hip fracture. This analysis does not support the routine use of DMC-THR over conventional bearing THR.
Description
© Copyright 2024
Macdonald et al. This is an open access
article distributed under the terms of the
Creative Commons Attribution License CC BY 4.0., which permits unrestricted use,
distribution, and reproduction in any
medium, provided the original author and
source are credited
Citation
Macdonald, H.; Gardner, A.; Sayers, A.; Evans, J. and Whitehouse, MR. (2024) 'A Meta-Analysis to Evaluate Implant Survival and Benefits of the Use of Dual Mobility Constructs in Total Hip Replacement Following Hip Fracture', Cureus, 16(4) e58755 Available at: https://doi.org/10.7759/cureus.58755
Publisher
Springer
License
Copyright © 2024, Macdonald et al.
Journal
Cureus
Volume
16
Issue
4
PubMed ID
ISSN
2168-8184