Total hip replacement: A meta-analysis to evaluate survival of cemented, cementless and hybrid implants

Table 4 Summary of finding table comparing hybrid and cementless total hip replacement

Outcomes	Illustrative comparative risks7 (95%CI)		Relative effect(95%CI)	No of participants(studies)	Quality of the evidence(GRADE)	Comments
	Assumed risk	Corresponding risk
	Cementless	Hybrid
Revision of any component due to any reason - Cohort Follow-up: 1 to 17.3 yr	Study population		RR 1.03 (0.69 to 1.54)	706 (4 studies)	+--- very low1,2
	105 per 1000	108 per 1000 (72 to 161)
	Moderate
	106 per 1000	109 per 1000 (73 to 163)
Revision of any component due to any reason - Register or Cohort of register Follow-up: 4 to 7 yr	Study population		RR 0.69 (0.64 to 0.74)	81635 (3 studies)	+--- very low2,3,4
	33 per 1000	23 per 1000 (21 to 25)
	Moderate
	39 per 1000	27 per 1000 (25 to 29)
Revision of any component due to any reason - All types of study Follow-up: 1 to 18.4 yr	Study population		RR 0.7 (0.65 to 0.75)	82560 (8 studies)	+--- very low2,5,6
	34 per 1000	24 per 1000 (22 to 26)
	Moderate
	116 per 1000	81 per 1000 (75 to 87)
Revision of any component due to aseptic loosening - Cohort Follow-up: 6.7 to 17.3 yr	Study population		RR 0.84 (0.47 to 1.51)	447 (3 studies)	+--- very low1,2
	76 per 1000	64 per 1000 (36 to 115)
	Moderate
	20 per 1000	17 per 1000 (9 to 30)
Revision of any component due to aseptic loosening - All types of study Follow-up: 6.7 to 17.3 yr	Study population		RR 0.85 (0.49 to 1.5)	666 (4 studies)	+--- very low1,2,6
	58 per 1000	49 per 1000 (28 to 86)
	Moderate
	19 per 1000	16 per 1000 (9 to 28)
Revision of any component due to infection - Register or Cohort of register Follow-up: 0 to 14 yr	Study population		Not estimable	72197 (2 studies)	+--- very low2,4
	4 per 1000	0 per 1000 (0 to 0)
	Moderate
Revision of any component due to infection - All types of study Follow-up: 0 to 18.4 yr	Study population		RR 1.47 (0.93 to 2.34)	72863 (5 studies)	+--- very low1,2,6
	4 per 1000	6 per 1000 (4 to 10)
	Moderate
	0 per 1000	0 per 1000 (0 to 0)
Dislocation of any component - Register or Cohort of register Follow-up: 5 to 7 yr	Study population		RR 1.12 (0.97 to 1.3)	75114 (2 studies)	+--- very low1,2,4
	9 per 1000	10 per 1000 (9 to 11)
	Moderate
	10 per 1000	11 per 1000 (10 to 13)
Dislocation of any component - All types of study Follow-up: 5 to 18.4 yr	Study population		RR 1.13 (0.98 to 1.3)	75333 (3 studies)	+--- very low1,2,6
	9 per 1000	10 per 1000 (9 to 11)
	Moderate
	9 per 1000	10 per 1000 (9 to 12)

CI: Confidence interval; RR: Risk ratio; GRADE Working Group grades of evidence; High quality: Further research is very unlikely to change our confidence in the estimate of effect; moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; very low quality: We are very uncertain about the estimate.

¹95% confidence interval around the pooled or best estimate of effect includes both (1) no effect and (2) appreciable benefit or appreciable harm (> 25%);

²No explanation was provided;

³Unexplained heterogeneity;

⁴Indirect studies from registers;

⁵Overall result from all types of study;

⁶High heterogeneity, explained by meta-regression;

⁷The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95%CI).