Evidence map›Paper›PMID 37831198›Full record

SynthesisArchives of orthopaedic and trauma surgery2024

The impact of retaining the femoral stem in revision total hip arthroplasty: a systematic review, meta-analysis, and meta-regression.

Mohammad Poursalehian, Sahar Zafarmandi, Mohammadreza Razzaghof, Seyed Mohammad Javad Mortazavi

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Mohammad PoursalehianOrthopedic Surgery Department, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, 1419733141, Iran.
Sahar ZafarmandiOrthopedic Surgery Department, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, 1419733141, Iran.
Mohammadreza RazzaghofOrthopedic Surgery Department, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, 1419733141, Iran.
Seyed Mohammad Javad MortazaviOrthopedic Surgery Department, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, 1419733141, Iran. smjmort@yahoo.com.ORCID http://orcid.org/0000-0003-4189-7777

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe management of well-fixed femoral stems in revision total hip arthroplasty (rTHA) remains a subject of debate, with concerns over potential complications arising from stem retention. This study aimed to investigate the re-revision rates due to aseptic loosening of the stem, overall re-revision rates, dislocation rates, and factors influencing these outcomes in rTHA with a retained well-fixed femoral stem. MATERIALS AND

methodsA systematic search was conducted across several databases including PubMed, EMBASE, and CENTRAL to identify pertinent publications from their inception through 2023. We specifically focused on studies that reported outcomes of rTHA with retained well-fixed femoral stems. The study designs incorporated in our research encompassed both cohort studies and case series studies. Thirty-five studies involving isolated acetabular revision and retaining the stem were included, representing a total of 3497 patients. Data extraction was tailored to the study questions. Meta-analyses, meta-regression, and subgroup analyses were conducted to evaluate the outcomes and their relationship with various factors. Pooled results, meta-regression, and subgroup analyses were performed using random-effects models. To assess and reduce bias, we employed Egger's test and the trim and fill method.

resultsThe meta-analysis included 3497 patients with a mean follow-up of 9.28 years. The 10-year risk of re-revision after retaining femoral stem using highly cross-linked polyethylene was 1.7% (95% CI 1.1%-2.3%; I

conclusionThe re-revision rate due to aseptic loosening of the retained stem during rTHA was found to be significantly low, supporting the idea of retaining well-fixed stems during rTHA. The overall re-revision and dislocation rates also presented comparable or better outcomes to prior studies. A range of factors, including the use of highly cross-linked polyethylene and ceramic femoral heads, was found to influence these outcomes. LEVEL OF EVIDENCE: IV. PROSPERO REGISTRATION NUMBER: CRD42022351157.

Indexed as

Arthroplasty, Replacement, HipHip ProsthesisJoint DislocationsFollow-Up StudiesHumansPolyethyleneProsthesis DesignProsthesis FailureReoperationRetrospective StudiesPolyethyleneAseptic looseningMeta-analysisRe-revisionRetained stemRevision total hip arthroplasty

Identifiers

PMID37831198

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.