Meta-Analysis Of The Efficacy Of Simultaneous And Staged Bilateral Total Hip Arthroplasty In Chinese Patients

Objective:To compare efficacy of simultaneous versus staged bilateral total hip arthroplasty in Chinese patients.Method:The database of PubMed,Embase,Cochrane library,Web of science,CNKI and Wanfang Database were searched online.And manually searching the relevant magazines,as far as possiblem,such as unpublished academic papers and monographs and other grey literature.Languages are restricted to Chinese and English literature,the time limit is set to build the library until January 2020,All the clinical controlled trials comparing simultaneous versus staged bilateral total hip arthroplasty were included under the inclusion and exclusion criteria and the related data were extracted,the Review Manager 5.2 were used for data analysis.The evaluation indexes of the retrieved literature in this study included: operation time;hospital stay;blood loss volume;blood transfusion volume;postoperative Harris scores;hospitalization expenses;deep vein thrombosis;pulmonary embolism;wound infection and neuropsychiatric symptoms.Results:12 studies met the inclusion criteria,which included a total of 989 cases(539 simultaneous bilateral THA,450 staged bilateral THA).The results of meta-analysis showed that the operation time [MD=-14.83,95%CI(-25.69,-3.97),p=0.007],hospital stay[MD=-12.51,95%CI(-15.10,-9.93),p<0.0001] and blood loss volume[MD=-185.69,95%CI(-299.53,-71.85),p=0.001],hospitalization expenses[[MD=-1.51,95%CI(-1.93,-1.09),p<0.00001]were significantly better in simultaneous bilateral THA group than in staged bilateral THA group.The blood transfusion volume were significantly higher in simultaneous group.In addition,there was no significantly difference in the postoperative Harris scores,risk of deep vein thrombosis,pulmonary embolism,wound infection and neuropsychiatric symptoms(p>0.05).Conclusion:The current research evidence shows that the operation time,hospital stay,blood loss volume and hospitalization expenses were significantly better in the simultaneous bilateral THA group.but the blood transfusion volume were significantly higher in simultaneous group.However,due to the limitations of the quality of the included study and sample size,it still needs to be verified by large samples and high quality randomized controlled clinical trials.