META Analysis Concerning The Clinical Outcome Between HRA And THA

Objective:Hip Resurfacing Arthroplasty (HRA) is becoming increasingly popular in the area of surgery treating young patients who conventionally get more involved in sports. However, a lot of experts question the superiority of HRA over THA due to higher revision rate and metal ion induced allergy for the metal articulation. To analyze the clinical outcome of the two methods of surgery, we launched this META study.Methods:We utilized several major databases including Medline, OVID, Cochrane Center and CNKI. Apart from that, we looked through some grey literatures which are not published formally and some major orthopedics journals of Clinical Orthopedics and Related Research, Journal of Arthroplasty, JBJS, Chinese Journal of Orthopedics, Chinese Journal of Joint Surgery. All the retrieved896articles were assessed according to appraisal system recommended by Cochrane Center before7studies were put into META procedure. The outcome difference between HRA and THA was analyzed by Mean Deviation (MD) and Relative Risk (RR). Results:HRA performs better than THA in the WOMAC score (MD3.30, CI (1.30,8.34), p=0.01) while it does not show superiority over THA on the revision rate (MD-1.89, CI(-3.55,-0.23), p=0.03). The patients who had the HRA surgery were found shorter femoral offset than THA (MD-13.7, p=0.03) as well as more evident leg length discrepancy (MD-0.85, p=0.02). The heteropic ossification rate of HRA was found more distinct than THA (RR1.69, p<0.001). The couple shows neither different aseptic loosening rate (RR=0.69, p=0.9), nor inconsistent infection rate between each other (RR=0.46, p=0.1). In the respect of post-operation dislocation risk, HRA is no more than0.18time comparing THA (p<0.001).Conclusion:This study showed that it is statistically different that the patients who accepted HRA rehabilitate more favorably in the hip function while the prosthesis were less revised in the THA subjects. The HRA surgery is not capable of replacing THA completely. So far, it is no more than a temporary treatment for some young patients.