How to Write a Systematic Review

Wright, Rick W.; Brand, Richard A.; Dunn, Warren R.; Spindler, Kurt P.

doi:10.1097/blo.0b013e31802c9098

Cited by 481 publications

(405 citation statements)

References 42 publications

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“…We designed and conducted this systematic review according to the Cochrane standard. The reporting is in accordance with the PRISMA guidelines [24] and Wright et al [49].…”

Section: Methodsmentioning

confidence: 99%

All-polyethylene Tibial Components are Equal to Metal-backed Components: Systematic Review and Meta-regression

Nouta

Verra

Pijls

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Less than 1% of all primary TKAs are performed with an all-polyethylene tibial component, although recent studies indicate all-polyethylene tibial components are equal to or better than metal-backed ones. Questions/purposes We asked whether the metal-backed tibial component was clinically superior to the all-polyethylene tibial component in primary TKAs regarding revision rates and clinical functioning, and which modifying variables affected the revision rate.Methods We systematically reviewed the literature for clinical studies comparing all-polyethylene and metalbacked tibial components used in primary TKAs in terms of revision rates, clinical scores, and radiologic parameters including radiostereometric analysis (RSA). Meta-regression techniques were used to explore factors modifying the observed effect. Our search yielded 1557 unique references of which 26 articles were included, comprising more than 12,500 TKAs with 231 revisions for any reason. Results Meta-analysis showed no differences between the all-polyethylene and metal-backed components except for higher migration of the metal-backed components. Metaregression showed strong evidence that the all-polyethylene design has improved with time compared with the metalbacked design. Conclusions The all-polyethylene components were equivalent to metal-backed components regarding revision rates and clinical scores. The all-polyethylene components had better fixation (RSA) than the metal-backed components. The belief that metal-backed components are better than all-polyethylene ones seems to be based on studies from earlier TKAs. This might no longer be true for modern TKAs. Level of Evidence Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…We designed and conducted this systematic review according to the Cochrane standard. The reporting is in accordance with the PRISMA guidelines [24] and Wright et al [49].…”

Section: Methodsmentioning

confidence: 99%

All-polyethylene Tibial Components are Equal to Metal-backed Components: Systematic Review and Meta-regression

Nouta

Verra

Pijls

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…We conducted a structured search to identify all published literature related to hip resurfacing using PubMed, Medline, EMBASE, the Cochrane Database of Systematic Reviews, and the Internet using Google Scholar [67,91]. The search strategy comprised (1) an initial text search with the key words ''hip resurfacing'' to identify all potentially relevant articles for inclusion; and (2) a modified search using ''hip resurfacing'' with the modifier and in combination with a specific keyword (ie, obesity, osteonecrosis, metal ion, etc.).…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

Is Patient Selection Important for Hip Resurfacing?

Nunley¹,

Valle²,

Barrack³

2009

Clinical Orthopaedics &Amp; Related Research

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The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing due to improved design and manufacturing of implants, better materials, enhanced implant fixation, theoretical advantages over conventional total hip arthroplasty, and recent Food and Drug Administration approval of two devices. Recent studies indicate satisfactory short-and midterm clinical results (1-to 10-year followup) with low complication rates, but there is a learning curve associated with this procedure, a more extensive surgical approach is necessary, and long-term results have yet to be determined. Proper patient selection may help avoid complications and improve patient outcomes. Patient selection criteria in the literature appear based predominantly on theoretical considerations without any consensus on stratifying patient risk. The most commonly reported complications encountered with hip resurfacing include femoral neck fracture, acetabular component loosening, metal hypersensitivity, dislocation, and nerve injury. At the time of clinical evaluation, patient age; gender; diagnosis; bone density, quality, and morphology; activity level; leg lengths; renal function; and metal hypersensitivity are important factors when considering a patient for hip resurfacing. Based on our review, we believe the best candidates for hip resurfacing are men under age 65 with osteoarthritis and relatively normal bony morphology. Level of Evidence: Level V, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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“…All authors were in agreement and any minor differences were resolved after discussion. A systematic review [64] was performed, using the Cochrane guidelines [66], due to the heterogeneous nature of the subject matter and the dissimilarity of the articles with respect to the methodology and outcome measures. The studies were selected by their levels of evidence (Fig.…”

Section: Methodsmentioning

confidence: 99%

Factors Influencing Early Rehabilitation After THA: A Systematic Review

Sharma

Morgan

Cheng

2009

Clin Orthop Relat Res

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A wide variation exists in rehabilitation after total hip arthroplasty (THA) in part due to a paucity of evidence-based literature. We asked whether a minimally invasive surgical approach, a multimodal approach to pain control with revised anesthesia protocols, hip restrictions, or preoperative physiotherapy achieved a faster rehabilitation and improved immediate short-term outcome. We conducted a systematic review of 16 level I and II studies after a strategy-based search of English literature on OVID Medline, PubMed, CINAHL, Cochrane, and EMBASE databases. We defined the endpoint of assessment as independent ambulation and ability to perform activities of daily living. Literature supports the use of a multimodal pain control to improve patient compliance in accelerated rehabilitation. Multimodal pain control with revised anesthesia protocols and accelerated rehabilitation speeds recovery after minimally invasive THA compared to the standard approach THA, but a smaller incision length or minimally invasive approach does not demonstrably improve the short-term outcome. Available studies justify no hip restrictions following an anterolateral approach but none have examined the question for a posterior approach. Preoperative physiotherapy may facilitate faster postoperative functional recovery but multicenter and welldesigned prospective randomized studies with outcome measures are necessary to confirm its efficacy.

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How to Write a Systematic Review

Cited by 481 publications

References 42 publications

All-polyethylene Tibial Components are Equal to Metal-backed Components: Systematic Review and Meta-regression

All-polyethylene Tibial Components are Equal to Metal-backed Components: Systematic Review and Meta-regression

Is Patient Selection Important for Hip Resurfacing?

Factors Influencing Early Rehabilitation After THA: A Systematic Review

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