The purpose of this study was to summarise the best evidence to assess radiological outcomes of highly crosslinked polyethylene compared with conventional polyethylene in total hip arthroplasty. All randomised, controlled clinical trials comparing highly cross-linked polyethylene with conventional polyethylene were sought and then analysed by two independent reviewers using the Cochrane collaboration guidelines. Eight studies in seven articles were identified as eligible for inclusion. Due to the clinical and methodological heterogeneity, data from the studies included could not be pooled. No failures related to highly cross-linked polyethylene were reported. All highly cross-linked polyethylene groups had a significantly lower wear or penetration than conventional polyethylene groups. This preliminary result suggests that highly cross-linked polyethylene has significantly less wear than conventional polyethylene.Résumé Le but de cette étude est de résumer les données indiscutables dans les prothèses totales de hanche concernant l'évaluation du devenir radiologique du polyéthylène hautement réticulé comparé au polyéthylène conventionnel. Tous les essais contrôlés, randomisés comparant le polyéthylène hautement réticulé au polyéthylène conventionnel ont été analysés par deux reviewers indépendants à partir de la base de Cochrane. 8 études dont 7 articles ont été identifiés et inclus dans ce travail. Du fait de l'hétérogénéicité clinique et méthodologique de ces études, toutes les données n'ont pu être regroupées. Aucun échec du polyéthylène hautement réticulé n'a été rapporté. Dans ces études, tous les groupes concernant le polyéthylène hautement réticulé et ont une usure et une pénétration plus basses que le polyéthylène conventionnel ceci de façon significative. Ces données préliminaires permettent de penser que le polyéthylène hautement réticulé a de façon significative moins d'usure que le polyéthylène conventionnel.
BackgroundVenous thromboembolism (VTE) is considered a potentially serious complication of knee arthroscopy and leads to conditions such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Low-molecular-weight heparin (LMWH) is widely employed in knee arthroscopy to reduce perioperative thromboembolic complications. However, the efficacy and safety of LMWH in knee arthroscopy remains unclear.MethodsSeven randomized controlled clinical trials on LMWH in knee arthroscopy were identified and included in this meta-analysis. The main outcomes of the effectiveness (prevention of DVT and PE) and complications (death, major bleeding, and minor bleeding) of LMWH in knee arthroscopic surgery were assessed using Review Manager 5.3 software.ResultsThe meta-analysis indicated that LMWH prophylaxis comprised 79% of asymptomatic DVT. No association was found in symptomatic VTE (RR: 0.90; 95% confidence interval [CI]: 0.39–2.08; P = 0.80), symptomatic DVT (RR: 0.79; 95% CI: 0.28–2.23; P = 0.66), symptomatic PE (RR: 1.36; 95% CI: 0.37–4.97; P = 0.64) and major bleeding (RR: 0.70; 95% CI: 0.12–3.95; P = 0.68) risk during LMWH prophylaxis were identified. Death was not reported in these studies. Moreover, there was a lower incidence of minor bleeding (RR: 0.64; 95% CI: 0.49 to 0.83; P = 0.001) in the control group than in the LMWH group.ConclusionCompared with the control group, the group treated with LMWH after knee arthroscopy was no association in reducing the symptomatic VTE rate, symptomatic DVT rate or symptomatic PE rate. The symptomatic VTE rate was 0.5% (11/2,166) in the LMWH group versus 0.6% (10/1,713) in the control group. Although the limitations of this meta-analysis cannot be ignored, the results of our study show that LMWH after knee arthroscopy is ineffective. We recommend that LMWH should not be routinely provided for knee arthroscopy.Trial registrationClinicalTrials.gov NCT03164746
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