摘要:
Objective:To investigate the clinical efficacy and perioperative safety of simultaneous or staged bilateral total hip arthroplasty(THA)using meta-analysis.Methods:Relevant retrieval methods were developed to retrieve PubMed,Embase,Cochrane Library,CNKI,Wanfang and VIP databases,and the time was set to build the database until September 2020.All the literatures related to simultaneous or staged total hip arthroplasty were screened out.The final included literatures were determined according to the inclusion and exclusion criteria,and the quality of the literatures was evaluated.Meta analysis of all indexes was performed using Review Manager 5.3 software.Results:A total of 22 articles were included,including 3415 patients.Meta analysis results showed that the total hospitalization time in the simultaneous group was significantly lower than that in the staged group[MD=-9.99,95%CI(-14.72,-5.26),P<0.0001].Total hospitalization expenses in the simultaneous group were lower than those in the staged group[MD=-1.3,95%CI(-1.73,-0.86),P<0.00001].The operative time in the simultaneous group was less than that in the staged group[MD=-27.08,95%CI(-40.89,-13.26),P=0.0001].The total blood loss in the simultaneous group was less than that in the staged group[MD=-176.55,95%CI(-282.5,-70.6),P=0.001].The surgical transfusion volume in the simultaneous group was higher than that in the staged group[MD=69.85,95%CI(40.48,99.22),P<0.00001].Postoperative Harris score of hip joint in the simultaneous group was higher than that in the staged group[MD=1.79,95%CI(0.8,2.79),P=0.0004].The incidence of operative complications in the simultaneous group was lower than that in the staged group[OR=0.73,95%CI(0.56,0.96),P<0.05].Conclusion:Compared with staged bilateral total hip replacement,simultaneous bilateral total hip replacement has advantages in terms of reducing hospitalization time,saving hospitalization expense,shortening operation time and reducing surgical bleeding amount,and can promote postoperative hip function recovery,reduce postoperative complications,but increase total blood transfusion volume.