Evidence map›Paper›PMID 40234929›Full record

SynthesisJournal of orthopaedic surgery and research2025

The efficacy of total hip arthroplasty in patients with systemic lupus erythematosus: a systematic review and meta-analysis.

Jun Lu, Jiangting Yu, Xiaoping Wang, Tingting Hua

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. 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.

Jun Lu *Hangzhou Fuyang Hospital of TCM Orthopedics and Traumatology, 418 Fengpu Road, Hangzhou, Zhejiang Province, 311499, China.
Jiangting Yu *Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China.
Xiaoping WangHangzhou Fuyang Hospital of TCM Orthopedics and Traumatology, 418 Fengpu Road, Hangzhou, Zhejiang Province, 311499, China.
Tingting HuaHangzhou Fuyang Hospital of TCM Orthopedics and Traumatology, 418 Fengpu Road, Hangzhou, Zhejiang Province, 311499, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSystemic lupus erythematosus (SLE) can lead to avascular necrosis (AVN) of the femoral head, often requiring total hip arthroplasty (THA). However, outcomes and complications of THA in SLE patients remain unclear. This study aims to analyze the differences in clinical outcomes and complications between SLE and non-SLE patients undergoing THA.

methodsThis study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42024564792). Literature was retrieved from the Cochrane Library, Web of Science, PubMed, and Embase databases, supplemented by manual searches of relevant references. Studies meeting specific diagnostic criteria were included, with eligible study types comprising case-control and cohort studies. The intervention of interest was THA surgery, and primary outcome measures included adverse events and clinical outcomes. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. Statistical analyses were performed using RevMan 5.4 software. Dichotomous variables were analyzed using relative risk (RR), while continuous variables were assessed using the mean difference (MD) or standardized mean difference (SMD), both with 95% confidence intervals for effect size estimation. Heterogeneity was assessed via the X² test and I² statistic, with P ≤ 0.05 considered statistically significant.

resultsNo significant difference in Harris Hip Scores (HHS) (MD= -0.69, 95% CI: -2.11 to 0.73, I²=0%, P = 0.34) was observed between SLE and non-SLE patients. However, compared to non-SLE patients, SLE patients had higher risks of prosthesis dislocation (RR = 2.44, 95% CI: 1.74 to 3.42, I²=52%, P<0.01), wound infection (RR = 2.30, 95% CI: 1.87 to 2.83, I²=0%, P<0.01), and blood transfusion (RR = 2.50, 95% CI: 2.14 to 2.92, I²=0%, P<0.01), as well as longer hospital stays (MD = 1.64, 95% CI: 1.44 to 1.64, I²=100%, P<0.01). DISCUSSION: In conclusion, although SLE patients show similar improvements in hip function postoperatively compared to non-SLE patients, they face a significantly higher risk of complications, including prosthetic dislocation, blood transfusion requirements, DVT, and wound infections. These patients also experience longer hospital stays and slower recovery, likely due to their underlying health conditions and preoperative treatments. Personalized management strategies and risk assessments are crucial to minimize complications and optimize recovery outcomes for SLE patients undergoing THA. However, the included studies exhibit significant heterogeneity, including variations in prosthesis types, fixation methods, sample sizes, and study designs, which may introduce potential bias and affect the generalizability of the findings. Further high-quality research is needed to address these issues.

Indexed as

Arthroplasty, Replacement, HipFemur Head NecrosisLupus Erythematosus, SystemicHumansPostoperative ComplicationsTreatment OutcomeSLESystemic lupus erythematosusTHATotal hip arthroplasty

Identifiers

PMID40234929
PMCPMC12001436

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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.