Abstract:
OBJECTIVES:To compare the clinical and cost effectiveness of total hip arthroplasty with resurfacing arthroplasty in patients with severe arthritis of the hip. DESIGN:Single centre, two arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation. SETTING:One large teaching hospital in the United Kingdom. PARTICIPANTS:126 patients older than 18 years with severe arthritis of the hip joint, suitable for resurfacing arthroplasty of the hip. Patients were excluded if they were considered to be unable to adhere to trial procedures or complete questionnaires. INTERVENTIONS:Total hip arthroplasty (replacement of entire femoral head and neck); hip resurfacing arthroplasty (replacement of the articular surface of femoral head only, femoral neck remains intact). Both procedures replaced the articular surface of the acetabulum. MAIN OUTCOME MEASURES:Hip function at 12 months after surgery, assessed using the Oxford hip score and Harris hip score. Secondary outcomes were quality of life, disability rating, physical activity level, complications, and cost effectiveness. RESULTS:60 patients were randomly assigned to hip resurfacing arthroplasty and 66 to total hip arthroplasty. Intention to treat analysis showed no evidence for a difference in hip function between treatment groups at 12 months (t test, P=0.242 and P=0.070 for Oxford hip score and Harris hip score, respectively); 95% of follow-up data was available for analysis. Mean Oxford hip score was 40.4 (95% confidence interval 37.9 to 42.9) in the resurfacing group and 38.2 (35.3 to 41.0) in the total arthroplasty group (estimated treatment effect size 2.23 (-1.52 to 5.98)). Mean Harris hip score was 88.4 (84.4 to 92.4) in the resurfacing group and 82.3 (77.2 to 87.5) in the total arthroplasty group (6.04 (-0.51 to 12.58)). Although we saw no evidence of a difference, we cannot definitively exclude clinically meaningful differences in hip function in the short term. Overall complication rates did not differ between treatment groups (P=0.291). However, we saw more wound complications in the total arthroplasty group (P=0.056) and more thromboembolic events in the resurfacing group (P=0.049). CONCLUSIONS:No evidence of a difference in hip function was seen in patients with severe arthritis of the hip, one year after receiving a total hip arthroplasty versus resurfacing arthroplasty. The long term effects of these interventions remain uncertain. TRIAL REGISTRATION:Current Controlled Trials ISRCTN33354155, UKCRN 4093.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Costa ML,Achten J,Parsons NR,Edlin RP,Foguet P,Prakash U,Griffin DR,Young Adult Hip Arthroplasty Team.doi
10.1136/bmj.e2147subject
Has Abstractpub_date
2012-04-19 00:00:00pages
e2147eissn
0959-8138issn
1756-1833journal_volume
344pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:To evaluate the risk of venous thromboembolic events associated with the use of progestin-only contraception and whether that risk differs with the mode of drug delivery (oral, intrauterine, or depot injection). DESIGN:Systematic review and meta-analysis of randomised controlled trials and observational stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e4944
更新日期:2012-08-07 00:00:00
abstract:OBJECTIVE:To investigate whether users of oral contraceptives and in [corrected] carriers of a hereditary prothrombotic condition (factor V Leiden mutation, protein C, S, or antithrombin deficiency) have an increased risk of cerebral sinus thrombosis. DESIGN:Comparison of a prospective series of cases of cerebral sinu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7131.589
更新日期:1998-02-21 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of dietary antioxidants in the primary prevention of age related macular degeneration (AMD). DESIGN:Systematic review and meta-analysis. DATA SOURCES:Search of seven databases without limits on year or language of publication, and retrieval of references in pertinent reviews an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39350.500428.47
更新日期:2007-10-13 00:00:00
abstract:OBJECTIVES:To determine the accuracy of diagnoses of schizophrenia and non-affective psychosis entered by general practitioners on a computer system. To compare recording of clinical events on computer with written records. DESIGN:Examination of case notes of all patients with a computer diagnosis of psychosis. Search...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6895.32
更新日期:1993-07-03 00:00:00
abstract:OBJECTIVES:To compare the frequency of discrepancies in retracted reports of clinical trials with those in adjacent unretracted reports in the same journal. DESIGN:Blinded case-control study. SETTING:Journals in PubMed. POPULATION:50 manuscripts, classified on PubMed as retracted clinical trials, paired with 50 adja...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h4708
更新日期:2015-09-20 00:00:00
abstract:OBJECTIVE:To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN:Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6756.835
更新日期:1990-10-13 00:00:00
abstract::This article presents a study on the sexual lifestyle of long distance lorry drivers in India. Using a questionnaire survey method, a total of 5709 consecutive long distance lorry drivers were interviewed by three trained investigators between March 1994 and August 1994. Results showed that 87% (4949 men) of subject...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7177.162
更新日期:1999-01-16 00:00:00
abstract:OBJECTIVE:To determine whether the link suggested between growth in utero and during infancy and death from cardiovascular disease in men is also present in women. DESIGN:Follow up study of women and men whose birth weight and weight at 1 year of age had been recorded. SETTING:Hertfordshire, England. SUBJECTS:5585 w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6918.1519
更新日期:1993-12-11 00:00:00
abstract:OBJECTIVES:To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN:Randomised c...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38558.393669.E0
更新日期:2005-09-03 00:00:00
abstract:OBJECTIVE:To determine the appropriateness of referrals from general practice to hospital outpatient departments. DESIGN:Prospective audit of referrals from a group practice over one year. SETTING:Six handed practice in a southern coastal town. SUBJECTS:All patients referred during the study period for whom a copy o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6701.722
更新日期:1989-09-16 00:00:00
abstract:OBJECTIVE:To assess the risk of bias associated with missing outcome data in systematic reviews. DESIGN:Imputation study. SETTING:Systematic reviews. POPULATION:100 systematic reviews that included a group level meta-analysis with a statistically significant effect on a patient important dichotomous efficacy outcome...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
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更新日期:2020-08-26 00:00:00
abstract:OBJECTIVE:To estimate the effectiveness of delivering an anthelmintic through a community child health programme on the weight gain of preschool children in Uganda. DESIGN:Cluster randomised controlled trial. SETTING:Eastern Uganda. PARTICIPANTS:48 parishes participating in a new programme for child health: 24 offer...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.38877.393530.7C
更新日期:2006-07-15 00:00:00
abstract:OBJECTIVES:To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation. DESIGN:Meta-analysis of prospective cohort studies. DATA SOURCES:Searches of Medline and Embase databases for articles published up to January 2012 using...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e1454
更新日期:2012-03-15 00:00:00
abstract:OBJECTIVES:To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome. DESIGN:Historical cohort study. SETTING:UK district health authority (population 960,000). PART...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7414.526
更新日期:2003-09-06 00:00:00
abstract::The development of a molecular genetics diagnostic service over a three year period was studied in a National Health Service region with a population of three million. Starting from a time when few diagnostic applications were possible, the number of disorders and the overall demand had grown rapidly. Conditions for w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6652.843
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:To determine whether elderly people can learn to use the inhaler used to deliver zanamivir (Relenza Diskhaler) as effectively as the Turbohaler and to identify which aspects of inhaler technique are most problematic. DESIGN:Randomised, controlled, intervention study. SETTING:Wards for acute elderly care in ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.322.7286.577
更新日期:2001-03-10 00:00:00
abstract:OBJECTIVE:To investigate the clinical effects of regulating umbilical cord clamping in preterm infants. DESIGN:A prospective randomised study. SETTING:The Queen Mother's Hospital, Glasgow. SUBJECTS:36 vaginally delivered infants over 27 and under 33 weeks' gestation. INTERVENTION:Holding the infant 20 cm below the ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.306.6871.172
更新日期:1993-01-16 00:00:00
abstract:OBJECTIVE:To provide a comprehensive survey of the content and quality of intervention studies relevant to the treatment of schizophrenia. DESIGN:Data were extracted from 2000 trials on the Cochrane Schizophrenia Group's register. MAIN OUTCOME MEASURES:Type and date of publication, country of origin, language, size o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7167.1181
更新日期:1998-10-31 00:00:00
abstract:OBJECTIVE:To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN:Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7106.449
更新日期:1997-08-23 00:00:00
abstract:OBJECTIVE:To investigate the impact of patients' preferences for the treatment of atrial fibrillation, by using individualised decision analysis combining probability and utility assessments into a decision tree. DESIGN:Observational study based on interviews with patients. SETTING:Eight general practices in Avon. P...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.320.7246.1380
更新日期:2000-05-20 00:00:00
abstract::In order to determine whether the loss in bone density seen in users of depot medroxyprogesterone acetate is reversible, a comparative study was undertaken in three groups of women. Group 1 consisted of 14 women who had used the contraceptive for at least 3 years and then discontinued use. Group 2 was 22 longterm us...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6923.247
更新日期:1994-01-22 00:00:00
abstract:OBJECTIVE:To determine whether a relation between urinary retention and temporal rhythms exists. DESIGN:Retrospective analysis of patients presenting over three years. SETTING:Urology departments in two hospitals. PATIENTS:815 Patients presenting as emergency admissions with urinary retention and requiring immediate...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6715.1560
更新日期:1989-12-23 00:00:00
abstract::The studies reviewed here show that the duration and severity of individual episodes of back pain can be lessened, reducing recurrences and their cost in terms of suffering and lost work. Frank examines differential diagnosis; acute, chronic, and intractable pain; and service implications. Modern management emphasises...
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pub_type: 杂志文章,评审
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更新日期:1993-04-03 00:00:00
abstract:OBJECTIVE:To determine the long term effects of antibiotic treatment for acute otitis media in young children. DESIGN:Prospective three year follow-up study within the framework of a primary care based, double blind, randomised, placebo controlled trial. SETTING:53 general practices in the Netherlands. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b2525
更新日期:2009-06-30 00:00:00
abstract:OBJECTIVE:To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN:Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING:Gothenburg, Sweden. SUBJEC...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6916.1385
更新日期:1993-11-27 00:00:00
abstract:OBJECTIVE:To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN:Retrospective cohort study. SETTING:Population based birth registry linked with health administrative databases in the pro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l4151
更新日期:2019-07-10 00:00:00
abstract:OBJECTIVE:To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy. DESIGN:Randomised, investigator blinded, controlled trial. SETTING:Large, public clinic associated with a referral hospital in Blantyre, Malawi. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.b1867
更新日期:2009-05-22 00:00:00
abstract::A committee of French bishops has contradicted the Vatican's condemnation of all methods of contraception by acknowledging that condom use may be necessary in order to prevent the spread of HIV and protect against AIDS. The Social Commission of the French Episcopate made this statement in a book entitled AIDS: Societ...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.312.7029.462a
更新日期:1996-02-24 00:00:00
abstract:OBJECTIVE:To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN:Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry of histopathology and cytopatho...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b1354
更新日期:2009-04-24 00:00:00
abstract:OBJECTIVE:To determine, using research on duloxetine for major depressive disorder as an example, if there are inconsistencies between protocols, clinical study reports, and main publicly available sources (journal articles and trial registries), and within clinical study reports themselves, with respect to benefits an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g3510
更新日期:2014-06-04 00:00:00