Capsular repair vs capsulectomy in total hip arthroplasty.

IF 6.7 2区医学 Q1 Medicine

British medical bulletin Pub Date : 2021-09-10 DOI:10.1093/bmb/ldab011

Luca Miranda, Marco Quaranta, Francesco Oliva, Attilio Giuliano, Nicola Maffulli

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引用次数: 5

Abstract

Background: A major complication of total hip arthroplasty is dislocation. The hip joint capsule can be incised and repaired, or can be excised.

Sources of data: We performed a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines focusing on capsular repair and capsulectomy.

Areas of agreement: We identified 31 articles (17 272 patients). Capsular repair produced a lower blood loss (465.2 vs 709.2 ml), and the procedure lasted 102.5 vs 96.08 min in patients who underwent capsulectomy. The patients undergoing capsulectomy experienced a dislocation rate of 3.06%, whereas in the patients undergoing capsular repair, the dislocation rate was 0.65%.

Areas of controversy: Most studies are retrospective observational studies, with no prospective randomized trials.

Growing points: Capsular preservation is association with a lower dislocation rate and a lower blood loss. Capsular excision does take statistically less time, but it is uncertain how a 6 min difference is clinically relevant.

Areas timely for developing research: Appropriately powered randomized clinical trials should be conducted to better define the association between the chosen implants, approach and outcome.

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全髋关节置换术中囊膜修复与囊膜切除。

背景:全髋关节置换术的主要并发症是脱位。髋关节囊可以切开修复，也可以切除。数据来源:我们按照系统评价和荟萃分析指南的首选报告项目对文献进行了系统回顾，重点是囊修复和囊切除术。一致领域:我们确定了31篇文章(17272例患者)。荚膜修复术的失血量较低(465.2 ml vs 709.2 ml)，手术时间为102.5 min vs 96.08 min。囊切除术患者脱位率为3.06%，而囊修复术患者脱位率为0.65%。争议领域:大多数研究是回顾性观察性研究，没有前瞻性随机试验。生长点:包膜保存与较低的脱位率和较低的失血有关。从统计学上讲，囊切除确实需要更少的时间，但尚不确定6分钟的差异在临床上是否相关。及时开展研究的领域:应该进行适当的随机临床试验，以更好地确定所选择的植入物、入路和结果之间的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British medical bulletin 医学-医学：内科

CiteScore

13.10

自引率

1.50%

发文量

审稿时长

>12 weeks

期刊介绍： British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.