Do Meta‐Analyses of Total Hip Arthroplasty Produce Reliable Results? A Systematic Review and Meta‐Epidemiological Study of Statistical Methods

Without HK adjustment, the results depend strongly on the heterogeneity estimator chosen and there is a risk of false positives, especially for the widely used DerSimonian and Laird heterogeneity estimator. For HK adjustment, the choice of heterogeneity estimator seems to play a less important role. We recommend the use of more reliable heterogeneity estimators as well as the HK adjustment as a measure to improve the statistical methodology of meta-analyses. This study highlights the critical need for improved statistical rigor in meta-analyses of THA, ensuring more reliable evidence for clinical decision-making and guideline development.