scholarly journals Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Lei Zhang ◽  
Jie Shen ◽  
Shengpeng Yu ◽  
Qiang Huang ◽  
Zhao Xie
Keyword(s):  
Blood Loss ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Plate Versus ◽  
Controlled Trials ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hip Screw

Background. Percutaneous compression plating (PCCP) has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation for the treatment of intertrochanteric fractures. The purpose of this meta-analysis was to estimate the outcomes and complications of the PCCP versus dynamic hip screw (DHS) fixation for intertrochanteric fractures.Methods. All randomized controlled trials (RCT) that compared PCCP with DHS in treating adult patients with intertrochanteric fractures were included. Main outcomes were collected and analysed using the RevMan 5.1 version.Results. Five trials met the inclusion criteria. Compared with DHS, PCCP had similar operation time (95% CI: −26.01~4.05,P= 0.15), length of hospitalization (95% CI: −1.79~1.25,P= 0.73), mortality (95% CI: 0.37~1.02,P= 0.06), incidence of implant-related complications (95% CI: 0.29~1.82,P= 0.49), and reoperation rate (95% CI: 0.41~3.05,P= 0.83). But blood loss (95% CI: −173.84~−4.81,P= 0.04) and transfusion need (95% CI: −0.53~−0.07,P= 0.01) significantly favored the PCCP.Conclusions. The PCCP was associated with reduced blood loss and less transfusion need, but similar to DHS in other respects. Owing to the limitations of this systematic review, more high-quality RCTs are still needed to assess the clinical efficiency of PCCP.

scholarly journals Proximal Femoral Nail versus Dynamic Hip Screw Fixation for Trochanteric Fractures: A Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao Huang ◽  
Frankie Leung ◽  
Zhou Xiang ◽  
Pei-Yong Tan ◽  
Jing Yang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Meta Analysis ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Controlled Trials ◽  
Trochanteric Fractures ◽  
Randomized Controlled ◽  
Femoral Nail ◽  
Hip Screw

Background. The purpose of this meta-analysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate.Methods. All randomized controlled trials comparing proximal femoral nail and dynamic hip screw in the treatment of trochanteric fractures were included. Articles and conference data were extracted by two authors independently. Data was analyzed using RevMan 5.1 version. Eight trials involving 1348 fractures were retrieved.Results. Compared with DHS fixation, PFN fixation had similar operation time (95% CI: −15.28–2.40,P=0.15). Blood loss and transfusion during perioperative time were also comparable between the two fixations (95% CI: −301.39–28.11,P=0.10; 95% CI: −356.02–107.20,P=0.29, resp.). Outcomes of hospital stay (95% CI: −0.62–1.01,P=0.64), wound complication (95% CI: 0.66–1.67,P=0.82), mortality (95% CI: 0.83–1.30,P=0.72), and reoperation (95% CI: 0.61–1.54,P=0.90) were all similar between the two groups.Conclusion. PFN fixation shows the same effectiveness as DHS fixation in the parameters measured.

scholarly journals Posterolateral Fusion Versus Posterior Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 219256822110164
Author(s):  
Elsayed Said ◽  
Mohamed E. Abdel-Wanis ◽  
Mohamed Ameen ◽  
Ali A. Sayed ◽  
Khaled H. Mosallam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Revision Rate ◽  
Meta Analysis ◽  
Posterior Lumbar Interbody Fusion ◽  
Operation Time ◽  
Controlled Trials ◽  
Lumbar Interbody Fusion ◽  
Randomized Controlled

Study Design: Systematic review and meta-analysis. Objectives: Arthrodesis has been a valid treatment option for spinal diseases, including spondylolisthesis and lumbar spinal stenosis. Posterolateral and posterior lumbar interbody fusion are amongst the most used fusion techniques. Previous reports comparing both methods have been contradictory. Thus, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to establish substantial evidence on which fusion method would achieve better outcomes. Methods: Major databases including PubMed, Embase, Web of Science and CENTRAL were searched to identify studies comparing outcomes of interest between posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF). We extracted data on clinical outcome, complication rate, revision rate, fusion rate, operation time, and blood loss. We calculated the mean differences (MDs) for continuous data with 95% confidence intervals (CIs) for each outcome and the odds ratio with 95% confidence intervals (CIs) for binary outcomes. P < 0.05 was considered significant. Results: We retrieved 8 studies meeting our inclusion criteria, with a total of 616 patients (308 PLF, 308 PLIF). The results of our analysis revealed that patients who underwent PLIF had significantly higher fusion rates. No statistically significant difference was identified in terms of clinical outcomes, complication rates, revision rates, operation time or blood loss. Conclusions: This systematic review and meta-analysis provide a comparison between PLF and PLIF based on RCTs. Although PLIF had higher fusion rates, both fusion methods achieve similar clinical outcomes with equal complication rate, revision rate, operation time and blood loss at 1-year minimum follow-up.

scholarly journals The Efficacy and Safety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-analysis

2020 ◽  
Author(s):  
Fan Yong Yong ◽  
deng bo ◽  
Hong Hai Nan ◽  
Zhu Zhong
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Randomized Controlled Trials ◽  
Hip Arthroplasty ◽  
Fibrin Sealant ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Transfusion Rate ◽  
Efficacy And Safety ◽  
Randomized Controlled

Abstract PurposeThe efficacy and safety of topical fibrin sealant (FS) compared with tranexamic acid (TXA) to reduce blood loss after total hip arthroplasty (THA) is not clear. A meta-analysis was conducted to evaluate the efficacy and safety of topical FS versus topical or intravenous TXA for treatment of primary THA.MethodWe searched electronic databases, including PubMed, Embase, and the Cochrane Library to identify studies up to March 2020. The references included in articles were also checked for additional potentially-relevant studies. The language of publication was limited to English. The endpoints included the mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and thrombotic events. Our meta-analysis was performed according to the Guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement. The data of the included studies were analyzed using RevMan 5.3.ResultsA total of four studies (two randomized controlled trials and two non-randomized controlled trials) met the inclusion criteria. Our meta-analysis demonstrated that TXA administration led to significantly different outcomes in terms of transfusion rate (RD = -0.12, 95% CI (-0.23, -0.00), P = 0.05, I2 = 74%) and postoperative hemoglobin levels (WMD = -0.47, 95% CI (-0.74, -021), P = 0.0005, I2 = 3%) compared with topical application of FS in patients undergoing THA. No significant difference was seen in total calculated blood loss (WMD = -86.22, 95% CI (-99.13, -73.31), P < 0.00001, I2 = 96%) or complication rate (RR = 0.98, 95% CI (-99.13, -73.31), P = 0.45, I2 = 0%) between the two groups.ConclusionsTXA administration can effectively decrease the transfusion rate and result in higher postoperative hemoglobin levels without increasing the rate of infection.

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