髋臼杯定位与髂腰肌撞击综合征患者全髋关节置换术后功能预后相关性的meta回归分析

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-07-02 DOI:10.1016/j.artd.2025.101760

Nikolai Ramadanov MD , Maximilian Voss MD , Robert Hable PhD , Robert Prill PhD , Marco Ezechieli MD , Roland Becker MD

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引用次数: 0

摘要

背景：研究髋关节置换术后IPI患者髋臼杯定位与功能结局之间的关系，Harris髋关节评分（HHS）测量。方法检索PubMed、CENTRAL、Epistemonikos和Embase截至2024年11月30日的文献。采用限制最大似然异质性估计器和Hartung-Knapp调整进行多水平随机效应荟萃分析。对合并数据进行逻辑回归，确定了髋臼杯倾斜和前倾与IPI相关的截止点，我们对纳入研究的合并数据进行了逻辑回归分析。结果最终纳入32项研究，共1755例患者。非ipi亚组(平均：91.5；置信区间[CI]: 88.2-94.9；I2 = 98%；τ2 = 48.7；P & lt;.01)与IPI亚组相比，tha后HHS的平均值更高(平均值：83.3；置信区间:78.0—-88.7;I2 = 96%；τ2 = 48.7；P & lt;. 01)。非ipi亚组(平均：42.2；置信区间:40.6—-43.8;I2 = 97%；τ2 = 10.3；P & lt;.01)与IPI亚组相比，髋臼杯倾角较低(平均：45.4；置信区间:43.3—-47.6;I2 = 71%；τ2 = 10.3；P & lt;.01) (f = 6.1；Df = 1,43；P = .02)。两个亚组髋臼杯前倾无差异(F = 3.8；Df = 1,32；P = .06)。杯倾角（P = 0.26）和前倾（P = 0.67）与tha后HHS无显著相关性。杯子倾斜度和前倾度的最佳临界值分别为≤44.1°和≥18.7°。结论髋臼杯倾角≤44.1°、前倾≥18.7°可降低THA术后IPI风险。这些发现为优化髋臼杯定位以获得更好的患者预后迈出了一步。

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Meta-Regression Analysis of the Association Between Acetabular Cup Positioning and Functional Outcome for Patients With Iliopsoas Impingement Syndrome After Total Hip Arthroplasty

Background

To examine the association between acetabular cup positioning and functional outcomes, measured with Harris Hip Score (HHS), in IPI patients after THA.

Methods

A literature search was conducted in PubMed, CENTRAL, Epistemonikos, and Embase up to November 30, 2024. A multilevel random-effects meta-analysis was performed with a restricted maximum likelihood heterogeneity estimator and Hartung-Knapp adjustment. Logistic regression on pooled data identified acetabular cup inclination and anteversion cut-offs associated with IPI, we performed logistic regression analysis on pooled data from the included studies.

Results

Ultimately, 32 studies with overall 1755 patients were included. The non-IPI subgroup (mean: 91.5; confidence interval [CI]: 88.2-94.9; I² = 98%; τ² = 48.7; P < .01) had a higher mean post-THA HHS compared with the IPI subgroup (mean: 83.3; CI: 78.0-88.7; I² = 96%; τ² = 48.7; P < .01). The non-IPI subgroup (mean: 42.2; CI: 40.6-43.8; I² = 97%; τ² = 10.3; P < .01) had a lower acetabular cup inclination compared with the IPI subgroup (mean: 45.4; CI: 43.3-47.6; I² = 71%; τ² = 10.3; P < .01) (F = 6.1; df = 1, 43; P = .02). There was no difference between the 2 subgroups in acetabular cup anteversion (F = 3.8; df = 1, 32; P = .06). There was no significant association between cup inclination (P = .26) or anteversion (P = .67) and post-THA HHS. The optimal cut-offs for cup inclination and anteversion were ≤ 44.1° and ≥ 18.7°, respectively.

Conclusions

Acetabular cup inclination ≤ 44.1° and anteversion ≥ 18.7° may lower IPI risk following THA. These findings represent a step toward optimizing acetabular cup positioning for a better patient outcome.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.