Meta-Analysis
Copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2023; 14(8): 630-640
Published online Aug 18, 2023. doi: 10.5312/wjo.v14.i8.630
Table 1 Newcastle-Ottawa Scale for assessing the quality of observational studies
Ref. Selection Comparability Exposure Total Representativeness of the exposed cohort Selection of the non-exposed cohort Ascertainment of exposure Demonstration that outcome of interest was not present at start of study Comparability of cohorts on the basis of the design or analysis Assessment of outcome Was follow-up long enough for outcomes to occur Adequacy of follow up of cohorts Total number of stars Tyson et al [39 ], 2021 * * * * ** * * * 9 Weiss et al [38 ], 2011 * * * * * * * * 8 Iorio et al [6 ], 2008 * * - * * * * * 7
Table 2 Study characteristics
Ref. Country Journal Study type Centres Level of evidence Number of stems Stem brand for cemented Stem brand for uncemented Tyson et al [39 ], 2021 Sweden Acta Orthopaedica Observational study Multi III 266 cemented, 601 uncemented Lubinus SPII 123 (46%), exeter 94 (35%), spectron 49 (18%) MP 291 (48%), restoration 162 (27%), wagner 78 (13%), revitan 70 (12%) Weiss et al [38 ], 2011 Sweden Acta Orthopaedica Observational study Multi III 1073 cemented, 812 uncemented Lubinus SPII 610 (57%), exeter long stem 248 (23%), spectron revision hip system 215 (20%) MP stem 812 (100%) Iorio et al [6 ], 2008 United States Journal of arthroplasty Prospective cohort study Single II 43 cemented, 43 uncemented 13 premise, 6 precision, 5 reliance (stryker), 3 re cemented, 2 charnley elite plus, 2 ultima, 1 PFC (depuy), 4 calcar replacing, 7 extra long S-ROM modular metaphyseal femoral stem 31 (72%), calcar replacing 9 (23%), extra long 3 (7.7%)
Table 3 Patient’s demographics
Ref. Gender M Age (SD) Follow up in years (SD) Tyson et al [39 ], 2021 Uncemented 318 (53%), cemented 138 (52%) Uncemented 72 (10), cemented 74 (9) Uncemented 4 (3), cemented 5 (3) Weiss et al [38 ], 2011 Uncemented 443 (55%), cemented 544 (51%) Uncemented 72 (11), cemented 76 (9) Uncemented 3.4 (2.9), cemented 4.2 (2.5) Iorio et al [6 ], 2008 22 cemented (51%), 22 uncemented (51%) Uncemented 71.2 (9), cemented 67.5 (10) Uncemented 7 (1), cemented 9 (1.5)
Table 4 Study characteristics for the studies about the uncemented stem
Ref. Total number Country Journal Study type Centres Level of evidence Mahoney et al [20 ], 2010 40 United States JOA ORS Single 3 Hasegawa et al [22 ], 2021 45 Japan International Orthopaedics ORS Single 3 Zheng et al [23 ], 2021 34 China OSJ ORS Single 3 Wallace et al [24 ], 2020 55 United Kingdom J Arthroplasty ORS Single 3 Zang et al [25 ], 2019 40 China/Japan JOS (Hong Kong) ORS Single 3 Herry et al [26 ], 2019 116 Multi International Orthopaedics ORS Multi 3 Shen et al [27 ], 2014 34 China COAJ ORS Single 3 Wang et al [28 ], 2020 73 China Hip International ORS Single 3 Singh et al [34 ], 2013 53 India IJO ORS Single 3 Tsukeoka et al [41 ], 2011 14 Japan Modern Rheumatology ORS Single 3 Oetgen et al [29 ], 2008 28 United States JOT ORS Single 3 Sotereanos et al [36 ], 2006 16 United States JBJS ORS Single 3 Philippot et al [35 ], 2009 43 France OTSR ORS Single 3 Thorey et al [30 ], 2008 79 Germany AOTS ORS Single 3 Malkani et al [31 ], 1996 74 United States JOA ORS Single 3 Mulliken et al [32 ], 1996 66 Canada CORR ORS Single 3 Meding et al [33 ], 1994 24 United States JOA ORS Single 3
Table 5 Patients demographic for the study involved uncemented stem
Ref. Gender male/female Age in years (SD) Follow up in years (SD) Mahoney et al [20 ], 2010 18/22 64 (30.5) 10.2 (2.8) Zhao et al [21 ], 2009 12/8 65 (9.5) 3 (1.1) Hasegawa et al [22 ], 2021 12/33 62.6 (26) 13.8 (2.2) Zheng et al [23 ], 2021 16/18 63.9 (11.7) 9.1 (2.5) Wallace et al [24 ], 2020 19/36 66.4 (9.3) 13.2 (2.17) Zang et al [25 ], 2019 15/25 62 (19.5) 15.7 (7.1) Herry et al [26 ], 2019 55/61 68 (12) 10 (3) Shen et al [27 ], 2014 21/13 65 (13.5) 6 (1.5) Wang et al [28 ], 2020 33/42 62.6 (16.5) 12.6 (2) Singh et al [34 ], 2013 42/6 54.7 (15.3) 14 (4.5) Oetgen et al [29 ], 2008 18/10 59 (12) 5.5 (1.5) Sotereanos et al [36 ], 2006 9/7 66 (17.5) 7.4 (6.5) Philippot et al [35 ], 2009 10/33 54 (17.5) 5.3 (1.5) Thorey et al [30 ], 2008 33/46 72.4 (28.5) 4 (2) Malkani et al [31 ], 1996 40/ 34 67.1 (10.1) 6.8 (3.9) Mulliken et al [32 ], 1996 31/32 62 (12) 3 (1) Meding et al [33 ], 1994 17/7 63.8 (29) 3.6 (2)
Table 6 Study characteristics of the cemented stem
Ref. Country Journal Study type Canters Level of evidence Total number Gender male/female Age Follow up in years (SD) Te Stroet et al [14 ], 2014 Netherlands BJJ ROS Single centre 3 37 17/20 76 (39- 93) 9 (4) Randhawa et al [15 ], 2009 United Kingdom JOT ROS Single centre 3 57 27/30 73 (37-94) 3.25 (3) Stigbrand and Ullmark, 2017 Sweden JOA ROS Single centre 3 69 40/29 69 7 (3.2) Pallaver et al [19 ], 2018 Switzerland AOTS ROS Single 3 178 126/52 68.4 (36-90) 9.3 (5.2) Davis et al [17 ], 2003 United States JBJS ROS Single 3 48 27/21 67 (47-82) 6.5 (2) Turner et al [18 ], 1987 United States JOA ROS Single 3 165 81/84 62.1 (22-92) 6.7 (1.5)
Table 7 Outcomes of the uncemented stem
Ref. Intraoperative periprosthetic fracture (%) Aseptic loosening (%) Dislocation (%) Infection (%) Mahoney et al [20 ], 2010 1 (2.5) 1 (2.5) 13 (32.5) 1 (2.5) Hasegawa et al [22 ], 2021 1 (2.2) 1 (2.2) 1 (2.2) 0 (0) Zheng et al [23 ], 2021 7 (20.5) 3 (8.8) 1 (2.9) 3 (8.8) Wallace et al [24 ], 2020 2 (3.6) 0 (0) 3 (5.4) 2 (3.6) Zang et al [25 ], 2019 11 (27.5) 1 (2.5) 2 (5.0) 2 (5.0) Herry et al [26 ], 2019 12 (10.3) 4 (3.4) 2 (1.7) 3 (2.5) Shen et al [27 ], 2014 0 (0) 0 (0) 0 (0) 0 (0) Tsukeoka et al [41 ], 2011 9 (64.2) NA 1 (7.1) NA Wang et al [28 ], 2020 0 (0) 5 (6.8) 0 (0) 2 (2.7) Singh et al [34 ], 2013 0 (0) NA 3 (5.6) 7 (13.2) Oetgen et al [29 ], 2008 3 (10.7) 0 (0) 0 (0) NA Sotereanos et al [36 ], 2006 NA NA 0 (0) 0 (0) Philippot et al [35 ], 2009 2 (4.6) NA 1 (2.3) 3 (6.9) Thorey et al [30 ], 2008 16 (20.2) 2 (2.5) NA 2 (2.5) Malkani et al [31 ], 1996 34 (45.9) 5 (6.75) 2 (2.7) 1 (1.3) Mulliken et al [32 ], 1996 20 (30.3) 12(18.1) NA NA Meding et al [33 ], 1994 4 (16.6) 0 (0) 3 (12.5) 1 (4.1)
Table 8 Outcomes of the cemented stem
Ref. Periprosthetic fracture Aseptic loosening Dislocation Infection Te Stroet et al [14 ], 2014 9 (24.3) 0 (0) 3 (8.1) 4 (10.8) Randhawa et al [15 ], 2009 4 (7.0) 1 (1.7) 1 (1.7) 7 (12.2) Stigbrand and Ullmark, 2017 3 (4.3) 4 (5.7) 2 (2.8) NA Pallaver et al [19 ], 2018 2 (1.1) 3 (1.7) NA 6 (3.3) Davis et al [17 ], 2003 7 (14.5) 10 (20.8) 7 (14.5) 1 (2.0) Turner et al [18 ], 1987 34 (20.6) 7 (4.2) 4 (2.4) 3 (1.8)