初次全髋置换中羟基磷灰石涂层是否优于多孔涂层的meta分析

发布时间：2018-09-08 08:34

【摘要】：全髋置换中,使用多孔涂层还是羟基磷灰石涂层的效果哪一个更好一直存在争议,部分研究表明两者并无显著性差异,但是也有一些研究显示羟基磷灰石涂层优于多孔涂层。我们通过检索Pubmed、Medline、EMBASE和Cochrane图书馆等数据库,搜索词是(HA OR hydroxyapatite) AND ((total hip arthroplasty) OR (total hip replacement)) AND (RCT*OR randomiz*OR control*OR compar*OR trial*).我们主要评价指标是Harris评分和生存率,其余评价指标是骨溶解、透光线发生率和聚乙烯磨损率等。我们最终纳入12篇RCT和9篇对照试验。我们研究结果表明羟基磷灰石涂层能够提高术后Harris评分,减少大腿疼痛发生率、减少骨溶解发生率,但是在生存率、聚乙烯磨损率上并无显著性差异,亚组分析结果显示,生存率跟随访时间相关,如果给予足够的随访时间,羟基磷灰石涂层应该优于多孔涂层。羟基磷灰石的特性和假体设计能够影响大腿疼痛发生率、骨溶解和聚乙烯磨损等。
[Abstract]:In total hip arthroplasty, the effect of using porous coating or hydroxyapatite coating has been controversial. Some studies show that there is no significant difference between them, but some studies show that hydroxyapatite coating is better than porous coating. We search for databases such as Pubmed,Medline,EMBASE and Cochrane libraries, and the search term is (HA OR hydroxyapatite) AND (total hip arthroplasty) OR (total hip replacement) AND (RCT*OR randomiz*OR control*OR compar*OR trial*. Our main indicators were Harris score and survival rate, and the others were osteolysis, light transmission line rate and polyethylene wear rate. We eventually included 12 RCT and 9 controlled trials. Our results showed that hydroxyapatite coating could improve postoperative Harris score, reduce thigh pain and osteolysis, but there was no significant difference in survival rate, polyethylene wear rate, and subgroup analysis. Survival rate is related to follow-up time and hydroxyapatite coating should be superior to porous coating if sufficient follow-up time is given. Hydroxyapatite properties and prosthesis design can affect thigh pain, osteolysis and polyethylene wear.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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