Meta‐analysis of the Efficacy of the Anatomical Center and High Hip Center Techniques in the Treatment of Adult Developmental Dysplasia of the Hip
Notice bibliographique
Résumé
Background . In total hip arthroplasty for the treatment of adult developmental dysplasia of the hip, there is considerable controversy regarding the placement of the acetabular cup, anatomic center, and upward in acetabular reconstruction. This article explores the efficacy of the anatomical center technique and high hip center technique in the treatment of adult developmental dysplasia of the hip. Method . By searching for articles in the Cochrane Library, PubMed, CNKI, and Wanfang databases, we collected the literature on the treatment of adult developmental dysplasia of the hip by anatomical center and high hip center technology and screened the literature according to the inclusion and exclusion criteria. The Cochrane risk of bias assessment tool was used to assess the risk of bias of randomized controlled trials, the quality of the literature in retrospective cohort studies was assessed using the Newcastle–Ottawa scale, and the RevMan 5.4 software was used to analyze the extracted outcome indicators. Results . Nine studies were finally included, including one prospective cohort study, eight retrospective cohort studies, two high‐quality studies, and six moderate‐quality studies. The meta‐analysis results showed that the reconstruction of the acetabulum in two positions was significantly different in terms of operation time (WMD = −37, 95% CI: ‐45.25‐28.74, P < 0.00001), intraoperative blood loss (WMD = −91.88, 95% CI: ‐108.57‐75.19, P < 0.00001), postoperative drainage volume (WMD = 80.55, 95% CI: ‐140.56‐301.66, P = 0.48), time to ground (WMD = −0.68, 95% CI: ‐1.37‐0.0, P = 0.05), Harris score (WMD = −0.04, 95% CI: ‐0.91‐0.82, P = 0.92), lower limb length difference (WMD = 0.21, 95% CI: ‐0.22‐0.64, P = 0.33), WOMAC score (WMD = −1.24, 95% CI: ‐4.89‐2.41, P = 0.51), postoperative complications (RD = −0.02, 95% CI: ‐0.06‐0.02, P = 0.44), Trendelenburg sign (RD = −0.02, 95% CI: ‐0.02‐0.05, P = 0.31), limb lengthening (WMD = 0.85, 95% CI: 0.61‐1.09, P < 0.00001), prosthesis wear (WMD = 0.01, 95% CI: 0‐0.02, P = 0.17), and prosthesis loosening (RD = 0.01, 95% CI: ‐0.02‐0.04, P = 0.45). Conclusions . The high hip center technique can reduce operative time, intraoperative blood loss, and downtime. The anatomical center technique is superior to the high hip center technique in terms of limb lengthening. Compared with acetabular anatomical reconstruction, there was no significant difference in postoperative drainage, lower limb length difference, postoperative complications, Trendelenburg sign, and prosthesis survival or wear. For DDH patients who are not severely shortened in the lower limbs and have severe acetabular bone defects, joint surgeons can choose to reconstruct the acetabulum in the upper part to simplify the operation, reduce the trauma of the patient, and accelerate the recovery of the patient, and they can choose to adjust the length of the neck and the angle of the neck shaft to maintain the moment arm of the abductor muscle. A ceramic interface or a highly cross‐linked polyethylene interface minimizes the effect of hip response forces. To further evaluate the efficacy of the anatomical center technique and the high hip center technique in the treatment of adult developmental dysplasia of the hip, more large‐sample, high‐quality, long‐term follow‐up randomized controlled trials are still needed for verification.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».