HIPPY - Reviewing evidence for younger hip replacement patients
Research team and collaborators
Vincent Cheng lecturer in evidence synthesis
Jane Dennis Senior Research Associate
Andrew Beswick Research Fellow in Evidence Synthesis
Vikki Wylde Professor of Musculoskeletal Health
What we are doing
Different types of implants may be associated with different outcomes after hip replacement surgery. We will search all previous studies on implants for hip replacement and:
- update the evidence from randomised controlled trials on the risk of revision surgery by implant type
- bring together evidence to understand which factors may be contributing to different implants having different outcomes after hip replacement for younger and older patients
- provide estimates of revision risks that will inform the cost-effectiveness of the different implants for the NHS
- Inform statistical analyses of routine historical patient data
In our previous systematic review, we found 77 randomised controlled studies comparing hip implants.
15 studies including data from 3,177 participants had data on the number of revisions after hip replacement. No evidence was found that any implant was better than the cemented metal-on-polyethylene implant to reduce the risk of revision at 2- or 10-years post-surgery
31 studies including data from 2,888 participants who had data for the Harris Hip Score. The Harris Hip Score is a questionnaire used by surgeons to assess function after hip replacement. Again, no evidence was found that any implant was better than the cemented metal-on-polyethylene.
To learn more about the original review and its results, click here.
How we are doing it
Just as in the original review, we are currently searching new medical literature and registers of ongoing trials.
We are keen to identify reports of all completed randomised controlled trials comparing different implant combinations. We will be comparing the implants to the same combination as in the original review, the cemented metal-on-polyethylene implant. As before, our primary outcome is revision surgery at up to 2, 2-10, and 10 or more years after hip replacement. This time we will also attempt to conduct analyses of trials that included patient-reported questionnaires, if data are available, rather than just those including surgeon-reported outcomes.
What we hope to achieve
Following the completion of the update of the network systematic review, we plan conduct and publish an “umbrella review” to form an evidence-based picture on risk factors for implants failure and revision.
‘Umbrella’ reviews involve synthesis of the work of other researchers who have already conducted relevant systematic reviews; we will particularly seek those concentrating on prognostic factors. Our aim is to clearly define those groups of patients at risk of poor outcomes in the longer term, who may therefore benefit from specific interventions early on.
If you want to know more or be involved in our research, please contact: hippy-programme@bristol.ac.uk