Comments on: Aïm et al.: « One- or two-stage exchange for periprosthetic shoulder infection: Systematic review and meta-analysis » of F Aim, B Marion, Y Kerroumi, V Meyssonnier, S Marmor published in Orthop Traumatol Surg Res 2020;106:5-15

ObjectiveTo identify observational studies which used data from more than one primary care electronic health record (EHR) database, and summarise key characteristics including: objective and rationale for using multiple data sources; methods used to manage, analyse and (where applicable) combine data; and approaches used to assess and report heterogeneity between data sources.DesignA systematic review of published studies.Data sourcesPubmed and Embase databases were searched using list of named primary care EHR databases; supplementary hand searches of reference list of studies were retained after initial screening.Study selectionObservational studies published between January 2000 and May 2018 were selected, which included at least two different primary care EHR databases.Results6054 studies were identified from database and hand searches, and 109 were included in the final review, the majority published between 2014 and 2018. Included studies used 38 different primary care EHR data sources. Forty-seven studies (44%) were descriptive or methodological. Of 62 analytical studies, 22 (36%) presented separate results from each database, with no attempt to combine them; 29 (48%) combined individual patient data in a one-stage meta-analysis and 21 (34%) combined estimates from each database using two-stage meta-analysis. Discussion and exploration of heterogeneity was inconsistent across studies.ConclusionsComparing patterns and trends in different populations, or in different primary care EHR databases from the same populations, is important and a common objective for multi-database studies. When combining results from several databases using meta-analysis, provision of separate results from each database is helpful for interpretation. We found that these were often missing, particularly for studies using one-stage approaches, which also often lacked details of any statistical adjustment for heterogeneity and/or clustering. For two-stage meta-analysis, a clear rationale should be provided for choice of fixed effect and/or random effects or other models.

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Diagnosing a periprosthetic shoulder infection: A systematic review

Journal of Orthopaedics ◽

10.1016/j.jor.2021.07.012 ◽

2021 ◽

Vol 26 ◽

pp. 58-66

Author(s):

Julio J. Jauregui ◽

Andrew Tran ◽

Samir Kaveeshwar ◽

Vidushan Nadarajah ◽

Moiuz W. Chaudhri ◽

...

Keyword(s):

Systematic Review ◽

Shoulder Infection ◽

Periprosthetic Shoulder Infection

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A systematic review and meta-analysis of ALPPS versus two-stage hepatectomy (TSH)

HPB ◽

10.1016/j.hpb.2019.10.1086 ◽

2019 ◽

Vol 21 ◽

pp. S911

Author(s):

Y.-N. Shen ◽

X.-L. Bai ◽

T. Ma ◽

T.-B. Liang

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Two Stage

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What Markers Best Guide the Timing of Reimplantation in Two-stage Exchange Arthroplasty for PJI? A Systematic Review and Meta-analysis

Clinical Orthopaedics and Related Research ◽

10.1097/01.blo.0000534680.87622.43 ◽

2018 ◽

Vol 476 (10) ◽

pp. 1972-1983 ◽

Cited By ~ 7

Author(s):

Yong Seuk Lee ◽

Navin Fernando ◽

Kyung-Hoi Koo ◽

Hyun Jung Kim ◽

Hamed Vahedi ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Two Stage ◽

Exchange Arthroplasty

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Chronic infections in hip arthroplasties: comparing risk of reinfection following one-stage and two-stage revision: a systematic review and meta-analysis

Clinical Epidemiology ◽

10.2147/clep.s29025 ◽

2012 ◽

pp. 57 ◽

Cited By ~ 94

Author(s):

Jeppe Lange ◽

Troelsen ◽

Reimar Thomsen ◽

Soballe

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Chronic Infections ◽

Two Stage ◽

One Stage ◽

Hip Arthroplasties

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Correlation between body mass index and two-stage revision failure of periprosthetic joint infection following total joint arthroplasty: A systematic review and meta-analysis

Journal of Orthopaedic Surgery ◽

10.1177/23094990211055231 ◽

2021 ◽

Vol 29 (3) ◽

pp. 230949902110552

Author(s):

Junbiao Guo ◽

Shuxu Wu ◽

Huimin Wang ◽

Wenzhi Chen ◽

Xiaoqiang Deng

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Publication Bias ◽

Periprosthetic Joint Infection ◽

Total Joint Arthroplasty ◽

Subgroup Analysis ◽

Meta Analysis ◽

Joint Infection ◽

Joint Arthroplasty ◽

Two Stage

Background: Although the correlation between body mass index (BMI) and two-stage revision failure of periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) have been frequently reported, the results remain controversial. Therefore, the correlation between them was systematically evaluated and meta-classified in this study. Methods: Literature on the correlation between BMI and two-stage revision failure of PJI following TJA was retrieved in PubMed, Embase and Cochrane Library due May 2020. Stata 13.0 software and Cochrane Collaboration Review Manager software (RevMan version 5.3) were applied to data synthesis, subgroup analysis, analyses of publication bias, and sensitivity. Results: A total of 15 observational studies included 1267 patients, of which 15 studies were included in systematic review and 11 studies in meta-analysis. Eight studies found a correlation between BMI and two-stage revision failure of PJI following TJA, but seven other studies found no correlation. Meta-analysis found that the risk of two-stage revision failure of PJI following TJA significantly boosted by 3.53 times in patients with BMI ≥ 30 kg/m2 (OR = 3.53; 95% CI = 1.63–7.64 for the BMI ≥ 30 kg/m2 vs. BMI < 30 kg/m2) and the risk of two-stage revision failure of PJI following TJA significantly increased by 2.92 times in patients with BMI ≥ 40 kg/m2 ( OR = 2.92; 95% CI = 1.06–8.03 for the BMI ≥ 40 kg/m2 vs. BMI < 30 kg/m2). The subgroup analysis showed that significant association was observed among the studies performed in TKA ( OR = 3.63; 95% CI = 2.27–5.82), but not among those conducted in THA ( OR = 3.06; 95% CI = 0.42–22.19). A significant association remained consistent, as indicated by sensitivity analyses. Because there are too few studies that can be combined in the included studies, Egger’s and Begg’s tests were not performed. Conclusion: Meta-analysis suggests that the risk of two-stage revision failure of PJI following TJA significantly boosted in obese patients. However, because there may be publication bias of this study, combined overall systematically evaluated and meta-analysis results, we cannot yet conclude that BMI is associated with two-stage revision failure of PJI following TJA.

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