ABSTRACT

Background: This study aims to present an overview and critical appraisal of all previous studies comparing costs and outcomes of the different modes of fixation in total hip arthroplasty (THA). A secondary aim is to provide conclusions regarding the most cost-effective mode of implant fixation per gender and age-specific population in THA, based on high quality studies.

Methods: A systematic search was conducted to identify cost-effectiveness analyses (CEAs) comparing different modes of implant fixation in THA. Analysis of results was done with solely CEAs that had a high methodological quality.

Results: A total of 12 relevant studies were identified and presented, of which 5 were considered to have the methodological rigor for inclusion in the analysis of results. These studies found that either cemented or hybrid fixation was the most cost-effective implant fixation mode for most age- and gender-specific subgroups.

Conclusion: Currently available well performed CEAs generally support the use of cemented and hybrid fixation for all age-groups relevant for THA and both genders. However, these findings were mainly based on a single database and depended on assumptions made in the studies’ methodology. Issues discussed in this paper have to be considered and future work is needed.

摘要

背景：本研究旨在对之前所有比较全髋关节置换术 (THA) 中不同固定方式的成本和结果的研究进行概述和批判性评估。第二个目的是根据高质量的研究，提供关于 THA 中每个性别和年龄特定人群最具成本效益的种植体固定模式的结论。

方法：进行了系统搜索，以确定比较 THA 中不同种植体固定模式的成本效益分析 (CEA)。结果分析仅使用具有高方法学质量的 CEA 进行。

结果：共确定并提交了 12 项相关研究，其中 5 项被认为具有方法学上的严谨性，可纳入结果分析。这些研究发现，对于大多数特定年龄和性别的亚组，骨水泥或混合固定是最具成本效益的种植体固定模式。

结论：目前可用的性能良好的 CEA 通常支持对所有与 THA 相关的年龄组和两性使用骨水泥和混合内固定。然而，这些发现主要基于单一数据库，并取决于研究方法中的假设。必须考虑本文中讨论的问题，并且需要未来的工作。