Meta-analysis of use of highly cross-linked and conventional polyethylene liners in total hip arthroplasty / 中华创伤杂志

ABSTRACT

Objective To assess whether highly cross-linked polyethylene liners are superior to conventional polyethylene liners in total hip arthroplasty (THA).Methods Randomized controlled trials (RCTs) of highly cross-linked and conventional polyethylene liners in THA were retrieved from MEDLINE,PubMed,EMBASE,Cochrane Central,CBMdisc,CBM,and VIP.Until April 2012,reference lists of the included articles and related reviews were manually searched as supplements.Meta analysis was performed with RevMan 5.1.Mean difference (MD) was used to assess the linear wear rate in highly cross-linked group versus conventional group.Odds ratio (OR) was used to estimate the osteolysis and revision incidence in the two groups.Results Meta analysis indicated that the two-dimensional linear wear rate [MD =-0.08,95％ CI (-0.1,0.06),P ＜ 0.05],three-dimensional linear wear rate [MD=-0.15,95％CI (-0.22,0.08),P＜0.05],volumetric wear rate [MD=-53.03,95％ CI (-84.39,-21.67,P＜0.05],total linear wear [MD=-0.19,95％CI (-0.23,-0.15),P＜0.05],and osteolysis incidence [OR =0.23,95％ C1 (0.13,0.39),P ＜ 0.05] were significantly reduced in highly cross-linked group than in conventional group.There were no statistical differences between the two groups concerning the creep value of the polyethylene liners and revision incidence.Conclusions Highly cross-linked polyethylene liners for primary THA present a low incidence of wear and osteolysis.As the number and quality of the included studies are limited,a long-term follow-up of more large-sample and high-quality RCTs are needed to evidence the outcome.