Effect of cementing technique on aseptic stem loosening in cemented primary total hip arthroplasty: a systematic review and meta-analysis

Author:

Hanif Muhammad1,Arshad Naveed1ORCID,Habib Yasir2,Shami Ali Miraj3ORCID,Rehman Obaid Ur4ORCID,Rehman Muhammad1,Reyaz Muddasir5,Mumtaz Hassan6ORCID

Affiliation:

1. Islamabad Medical and Dental College

2. Shifa International hospital

3. Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU)

4. Rawalpindi Medical University (RMU), Rawalpindi, Pakistan

5. Northwick Park hospital London NHS, Harrow, UK

6. Maroof International Hospital Public Health Scholar: Health Services Academy, Islamabad

Abstract

Background and objective: Aseptic stem loosening after total hip arthroplasty surgery is the commonest complication, whether stem is cemented or uncemented. The aseptic cemented stem loosening has been a challenging problem over the years and a leading cause for revision since the inception of total hip arthroplasty. The objective of systematic review and meta-analysis was to determine the impact of cementing technique on aseptic stem loosening in total hip arthroplasty. Methods: Cochrane, CINAHL, Embase, Google scholar, Medline, PubMed were searched in 13 December 2020. Two independent investigators extracted the data and a third investigator’s involvement was reached on consensus. A total of 37 studies of revision rate due to aseptic loosening were reviewed by using fixed/random effects size and were grouped by cementing technique and studies’ characteristics. The data were analyzed through Meta-Essentials and RStudio. Results: In revision total hip arthroplasty, retained femoral components revisions rate due to aseptic loosening were recorded in 37 studies involving 6167 cases. Aseptic loosening rate collectively was 5.8% (CI 95%, 0.03–0.08) and mean follow-up of study was 12.5 years. The average follow-up period, mean age at index revision surgery and percentage of aseptic loosening were insignificantly associated with revision rate (P≥0.05), in meta-regression univariant analyses. Conclusion: This investigative analysis showed that there is a minimal difference between results of cementing techniques of total hip arthroplasty in femoral components in long-term follow-ups, and usually have a low risk of failure.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery

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