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Meta-Analysis
. 2020 Jul 31;15(1):293.
doi: 10.1186/s13018-020-01794-4.

Comparisons of the surface micromotions of cementless femoral prosthesis in the horizontal and vertical levels: a network analysis of biomechanical studies

Bomin Wang  1 , Qinghu Li  1 , Jinlei Dong  1 , Dongsheng Zhou  1 , Fanxiao Liu  2
Affiliations
Meta-Analysis

Comparisons of the surface micromotions of cementless femoral prosthesis in the horizontal and vertical levels: a network analysis of biomechanical studies

Bomin Wang et al. J Orthop Surg Res. .

Abstract

Background: Numerous quantitatively biomechanical studies measuring the fixation stability of femoral stem using micromotions at the bone-implant interfaces in different directions and levels remain inconclusive. This network meta-analysis performed systematically aims to explore the rank probability of micromotions at the bone-implant interfaces based on biomechanical data from studies published.

Methods: Two electronic databases, PubMed/MEDLINE and Embase, were utilized to retrieve biomechanical studies providing the data of micromotions at the bone-stem interfaces. After screening and diluting out, the studies that met inclusion criteria will be utilized for statistical analysis. In order to contrast the stability of commonness and differences of the different parts of the femoral stem, the horizontal and vertical comparison of micromotions at the bone-implant interfaces were conducted using the pooled evaluation indexes including the mean difference (MD) and the surface under the cumulative ranking (SUCRA) curve, while inconsistency analysis, sensitivity analysis, subgroup analyses, and publication bias were performed for the stability evaluation of outcomes.

Results: Screening determined that 20 studies involving a total of 249 samples were deemed viable for inclusion in the network meta-analysis. Tip point registered the highest micromotions of 13 measurement points. In the horizontal level, the arrangements of 4 measurement points at the proximal (P1-P4), middle (P5-P8) and distal part of the stem (P9-P12) were P1 = P2 = P3 = P4, P7 > P8 > P6 = P5 and P10 ≥ P12 = P9 = P11, respectively. In the vertical level, the arrangements of 3 measurement points at the anterior, posterior, medial, and lateral directions was P9 > P5 = P1, P10 > P6 > P2, P11 > P7 > P3, and P12 > P8 > P4, respectively.

Conclusion: The network meta-analysis seems to reveal that the distal part of the femoral stem is easier to register higher micromotion, and tip point of femoral stem registers the highest micromotions.

Keywords: Biomechanics; Femoral stem; Micromotion; Network meta-analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The schematic diagram of measuring micromotions of 13 measurement points at the bone-stem interfaces
Fig. 2
Fig. 2
Flow chart for the search selection of all included biomechanical studies
Fig. 3
Fig. 3
Network evidence for the comparison of micromotions in four directions at the proximal, middle, and distal portion of the femoral stem
Fig. 4
Fig. 4
Forest plots for the comparisons of micromotions between the femoral stem and bone in four directions at the horizontal (proximal, middle, and distal) and the vertical level (anterior, posterior, medial, and lateral)
Fig. 5
Fig. 5
Inconsistency test for direct and indirect comparisons of micromotions at the proximal, middle, and distal portion of the femoral stem
Fig. 6
Fig. 6
Rank probability for the comparisons of micromotions between femoral stem and bone in the horizontal level (proximal, middle, and distal)
Fig. 7
Fig. 7
Rank probability for the comparisons of micromotions between femoral stem and bone in the vertical level (anterior, posterior, medial, and lateral)
Fig. 8
Fig. 8
Publication bias of the comparison for micromotions of four directions in the proximal, middle, and distal portion of femoral stem
See this image and copyright information in PMC

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