Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2017

Open Access 01-12-2017 | Research article

Partial versus early full weight bearing after uncemented total hip arthroplasty: a meta-analysis

Authors: Peng Tian, Zhi-jun Li, Gui-Jun Xu, Xiao-lei Sun, Xin-long Ma

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2017

Login to get access

Abstract

Background

This meta-analysis aimed to investigate the efficacy and safety of partial weight bearing (PWB) versus early full weight bearing (FWB) after uncemented total hip arthroplasty (THA).

Methods

We conducted a search in PubMed, EMBASE, The Cochrane Library, and Web of Science for randomized controlled trials (RCTs) and non-RCTs comparing PWB and early FWB after uncemented THA. Two authors conducted the selection of studies, data extraction, and assessment of risk of bias independently. A pooled meta-analysis was performed using the RevMan 5.3 software.

Results

Six RCTs and three non-RCTs met the inclusion criteria. The meta-analysis indicated that compared with PWB, the FWB group showed greater femoral subsidence at 3-month follow-up (MD = −0.12, 95% CI −0.22 to −0.01, P = 0.03). There were no significant differences in the hip Harris score at 1-year and 2-year follow-up (MD = 1.54, 95% CI −0.83 to 3.90, P = 0.20; MD = 0.08, 95% CI −1.19 to 1.34, P = 0.90, respectively), in femoral subsidence at 2-year follow-up and at two additional years of follow-up (MD = −0.03, 95% CI −0.31 to 0.25, P = 0.84; (MD = −0.02, 95% CI −0.37 to 0.33, P = 0.91, respectively). There were no significant differences in the incidences of bone ingrowth fixation, spot welds, and radiolucent lines.

Conclusions

This meta-analysis shows that early FWB in patients with uncemented THA could be safe and could not increase the incidence of postoperative complications.
Literature
1.
go back to reference Kim C, Linsenmeyer KD, Vlad SC, Guermazi A, Clancy MM, Niu J, Felson DT. Prevalence of radiographic and symptomatic hip osteoarthritis in an urban United States community: the Framingham osteoarthritis study. Arthritis Rheumatology (Hoboken, NJ). 2014;66(11):3013–7.CrossRef Kim C, Linsenmeyer KD, Vlad SC, Guermazi A, Clancy MM, Niu J, Felson DT. Prevalence of radiographic and symptomatic hip osteoarthritis in an urban United States community: the Framingham osteoarthritis study. Arthritis Rheumatology (Hoboken, NJ). 2014;66(11):3013–7.CrossRef
2.
go back to reference Gross TP, Liu F. Risk factor analysis for early femoral failure in metal-on-metal hip resurfacing arthroplasty: the effect of bone density and body mass index. J Orthopaedic Surg Res. 2012;7:1.CrossRef Gross TP, Liu F. Risk factor analysis for early femoral failure in metal-on-metal hip resurfacing arthroplasty: the effect of bone density and body mass index. J Orthopaedic Surg Res. 2012;7:1.CrossRef
3.
go back to reference Marques EM, Humphriss R, Welton NJ, Higgins JP, Hollingworth W, Lopez-Lopez JA, Thom H, Hunt LP, Blom AW, Beswick AD. The choice between hip prosthetic bearing surfaces in total hip replacement: a protocol for a systematic review and network meta-analysis. Syst Rev. 2016;5:19.CrossRefPubMedPubMedCentral Marques EM, Humphriss R, Welton NJ, Higgins JP, Hollingworth W, Lopez-Lopez JA, Thom H, Hunt LP, Blom AW, Beswick AD. The choice between hip prosthetic bearing surfaces in total hip replacement: a protocol for a systematic review and network meta-analysis. Syst Rev. 2016;5:19.CrossRefPubMedPubMedCentral
4.
go back to reference Li T, Zhuang Q, Weng X, Zhou L, Bian Y. Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients: a meta-analysis. PLoS One. 2013;8(7):e68903.CrossRefPubMedPubMedCentral Li T, Zhuang Q, Weng X, Zhou L, Bian Y. Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients: a meta-analysis. PLoS One. 2013;8(7):e68903.CrossRefPubMedPubMedCentral
5.
go back to reference Gross TP, Liu F. The first 100 fully porous-coated femoral components in hip resurfacing. Bull NYU Hosp Jt Dis. 2011;69 Suppl 1:S30–35.PubMed Gross TP, Liu F. The first 100 fully porous-coated femoral components in hip resurfacing. Bull NYU Hosp Jt Dis. 2011;69 Suppl 1:S30–35.PubMed
6.
go back to reference Meding JB, Ritter MA, Davis KE, Hillery M. Cemented and uncemented total hip arthroplasty using the same femoral component. Hip Int. 2016;26(1):62–6.CrossRefPubMed Meding JB, Ritter MA, Davis KE, Hillery M. Cemented and uncemented total hip arthroplasty using the same femoral component. Hip Int. 2016;26(1):62–6.CrossRefPubMed
7.
go back to reference Gromov K, Pedersen AB, Overgaard S, Gebuhr P, Malchau H, Troelsen A. Do revision rates differ after first-time revision of primary THA with a cemented and cementless femoral component? Clin Orthop Relat Res. 2015;473(11):3391–8.CrossRefPubMedPubMedCentral Gromov K, Pedersen AB, Overgaard S, Gebuhr P, Malchau H, Troelsen A. Do revision rates differ after first-time revision of primary THA with a cemented and cementless femoral component? Clin Orthop Relat Res. 2015;473(11):3391–8.CrossRefPubMedPubMedCentral
8.
go back to reference Radl R, Aigner C, Hungerford M, Pascher A, Windhager R. Proximal femoral bone loss and increased rate of fracture with a proximally hydroxyapatite-coated femoral component. J Bone Joint Surg. 2000;82(8):1151–5.CrossRef Radl R, Aigner C, Hungerford M, Pascher A, Windhager R. Proximal femoral bone loss and increased rate of fracture with a proximally hydroxyapatite-coated femoral component. J Bone Joint Surg. 2000;82(8):1151–5.CrossRef
9.
go back to reference Andersson L, Wesslau A, Boden H, Dalen N. Immediate or late weight bearing after uncemented total hip arthroplasty: a study of functional recovery. J Arthroplasty. 2001;16(8):1063–5.CrossRefPubMed Andersson L, Wesslau A, Boden H, Dalen N. Immediate or late weight bearing after uncemented total hip arthroplasty: a study of functional recovery. J Arthroplasty. 2001;16(8):1063–5.CrossRefPubMed
10.
go back to reference Kishida Y, Sugano N, Sakai T, Nishii T, Haraguchi K, Ohzono K, Yoshikawa H. Full weight-bearing after cementless total hip arthroplasty. Int Orthop. 2001;25(1):25–8.CrossRefPubMedPubMedCentral Kishida Y, Sugano N, Sakai T, Nishii T, Haraguchi K, Ohzono K, Yoshikawa H. Full weight-bearing after cementless total hip arthroplasty. Int Orthop. 2001;25(1):25–8.CrossRefPubMedPubMedCentral
11.
go back to reference Rao RR, Sharkey PF, Hozack WJ, Eng K, Rothman RH. Immediate weightbearing after uncemented total hip arthroplasty. Clin Orthop Relat Res. 1998;349:156–62.CrossRef Rao RR, Sharkey PF, Hozack WJ, Eng K, Rothman RH. Immediate weightbearing after uncemented total hip arthroplasty. Clin Orthop Relat Res. 1998;349:156–62.CrossRef
12.
go back to reference Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712–6.CrossRefPubMed Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712–6.CrossRefPubMed
14.
go back to reference Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med. 1997;127(9):820–6.CrossRefPubMed Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med. 1997;127(9):820–6.CrossRefPubMed
15.
go back to reference Chan YK, Chiu KY, Yip DK, Ng TP, Tang WM. Full weight bearing after non-cemented total hip replacement is compatible with satisfactory results. Int Orthop. 2003;27(2):94–7.PubMedPubMedCentral Chan YK, Chiu KY, Yip DK, Ng TP, Tang WM. Full weight bearing after non-cemented total hip replacement is compatible with satisfactory results. Int Orthop. 2003;27(2):94–7.PubMedPubMedCentral
16.
go back to reference Boden H, Adolphson P. No adverse effects of early weight bearing after uncemented total hip arthroplasty: a randomized study of 20 patients. Acta Orthop Scand. 2004;75(1):21–9.CrossRefPubMed Boden H, Adolphson P. No adverse effects of early weight bearing after uncemented total hip arthroplasty: a randomized study of 20 patients. Acta Orthop Scand. 2004;75(1):21–9.CrossRefPubMed
17.
go back to reference Markmiller M, Weiss T, Kreuz P, Ruter A, Konrad G. Partial weightbearing is not necessary after cementless total hip arthroplasty: a two-year prospective randomized study on 100 patients. Int Orthop. 2011;35(8):1139–43.CrossRefPubMed Markmiller M, Weiss T, Kreuz P, Ruter A, Konrad G. Partial weightbearing is not necessary after cementless total hip arthroplasty: a two-year prospective randomized study on 100 patients. Int Orthop. 2011;35(8):1139–43.CrossRefPubMed
18.
go back to reference Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S. The effect of early weight bearing on migration pattern of the uncemented CLS stem in total hip arthroplasty. J Arthroplasty. 2007;22(8):1122–9.CrossRefPubMed Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S. The effect of early weight bearing on migration pattern of the uncemented CLS stem in total hip arthroplasty. J Arthroplasty. 2007;22(8):1122–9.CrossRefPubMed
19.
go back to reference Unver B, Karatosun V, Gunal I, Angin S. Comparison of two different rehabilitation programmes for thrust plate prosthesis: a randomized controlled study. Clin Rehabil. 2004;18(1):84–91.CrossRefPubMed Unver B, Karatosun V, Gunal I, Angin S. Comparison of two different rehabilitation programmes for thrust plate prosthesis: a randomized controlled study. Clin Rehabil. 2004;18(1):84–91.CrossRefPubMed
20.
go back to reference Thien TM, Ahnfelt L, Eriksson M, Stromberg C, Karrholm J. Immediate weight bearing after uncemented total hip arthroplasty with an anteverted stem: a prospective randomized comparison using radiostereometry. Acta Orthop. 2007;78(6):730–8.CrossRefPubMed Thien TM, Ahnfelt L, Eriksson M, Stromberg C, Karrholm J. Immediate weight bearing after uncemented total hip arthroplasty with an anteverted stem: a prospective randomized comparison using radiostereometry. Acta Orthop. 2007;78(6):730–8.CrossRefPubMed
21.
go back to reference Woolson ST, Adler NS. The effect of partial or full weight bearing ambulation after cementless total hip arthroplasty. J Arthroplasty. 2002;17(7):820–5.CrossRefPubMed Woolson ST, Adler NS. The effect of partial or full weight bearing ambulation after cementless total hip arthroplasty. J Arthroplasty. 2002;17(7):820–5.CrossRefPubMed
22.
go back to reference Sugano N, Saito S, Takaoka K, Ohzono K, Masuhara K, Saito M, Ono K. Spongy metal Lubeck hip prostheses for osteoarthritis secondary to hip dysplasia. A 2-6-year follow-up study. J Arthroplasty. 1994;9(3):253–62.CrossRefPubMed Sugano N, Saito S, Takaoka K, Ohzono K, Masuhara K, Saito M, Ono K. Spongy metal Lubeck hip prostheses for osteoarthritis secondary to hip dysplasia. A 2-6-year follow-up study. J Arthroplasty. 1994;9(3):253–62.CrossRefPubMed
23.
go back to reference Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990;257:107–28. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990;257:107–28.
24.
go back to reference Kim YH, Kim JS, Joo JH, Park JW. Is hydroxyapatite coating necessary to improve survivorship of porous-coated titanium femoral stem? J Arthroplasty. 2012;27(4):559–63.CrossRefPubMed Kim YH, Kim JS, Joo JH, Park JW. Is hydroxyapatite coating necessary to improve survivorship of porous-coated titanium femoral stem? J Arthroplasty. 2012;27(4):559–63.CrossRefPubMed
25.
go back to reference Leali A, Fetto J, Moroz A. Prevention of thromboembolic disease after non-cemented hip arthroplasty. A multimodal approach. Acta Orthop Belg. 2002;68(2):128–34.PubMed Leali A, Fetto J, Moroz A. Prevention of thromboembolic disease after non-cemented hip arthroplasty. A multimodal approach. Acta Orthop Belg. 2002;68(2):128–34.PubMed
Metadata
Title
Partial versus early full weight bearing after uncemented total hip arthroplasty: a meta-analysis
Authors
Peng Tian
Zhi-jun Li
Gui-Jun Xu
Xiao-lei Sun
Xin-long Ma
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2017
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-017-0527-x

Other articles of this Issue 1/2017

Journal of Orthopaedic Surgery and Research 1/2017 Go to the issue