Comparison of transverse and modified subtrochanteric femoral shortening osteotomy in total hip arthroplasty for developmental dysplasia of hip: a meta-analysis

BMC Musculoskeletal Disorders

Yue Ding¹  Maolin Zhang¹  Chi Zhang¹  Changchuan Li¹ 

[1] Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, No.107 on Yanjiangxi Road, Yuexiu District, 510120 Guangzhou, Guangdong, China

关键词: Meta-analysis;    Post-operative outcome;    Developmental dysplasia of the hip;    Total hip arthroplasty;    Subtrochanteric femoral shortening osteotomy;   

Others  :  1121999
DOI  :  10.1186/1471-2474-15-331

 received in 2014-06-11, accepted in 2014-09-29,  发布年份 2014

【 摘 要 】

Background

Subtrochanteric femoral shortening osteotomy is a crucial procedure to prevent nerve injury in total hip arthroplasty for severe developmental dysplasia of the hip. Transverse osteotomy was first applied, and other modified methods have also been reported. Each has its own advantages and limitations, but no definitive conclusions regarding differences in outcomes have been reached to date.

Methods

We therefore performed a comprehensive meta-analysis to compare the outcomes of different approaches. 37 studies (795 hips) were included in the final analysis. Meta-analysis, subgroup analysis and meta-regression were performed.

Results

Meta-analysis and subgroup analysis showed no significant difference between transverse and modified method. This is further confirmed by meta-regression. Method of osteotomy was found to be not associated with nonunion rate (P = 0.472), as well as other post-operative outcomes including nerve palsy (P = 0.240), dislocation (P = 0.735), revision (P = 0.653) and Harris hip score improvement (P = 0.562). In addition, western countries (P = 0.010) and duration of follow-up more than 5 years (P = 0.014) were associated with higher revision rate.

Conclusions

Transverse osteotomy and modified osteotomy appear to be equivalent in terms of nonunion, safety and efficacy. Transverse osteotomy may be recommended, due to its simplicity and convenience in adjusting the anteversion angle. Well-designed and large-sample-size randomized controlled trials are expected to confirm and update the findings of this analysis.

【 授权许可】

   
2014 Li et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Figure 2.

【 参考文献 】

• [1]Dezateux C, Rosendahl K: Developmental dysplasia of the hip. Lancet 2007, 369:1541-1552.
• [2]Peled E, Eidelman M, Katzman A, Bialik V: Neonatal incidence of hip dysplasia: ten years of experience. Clin Orthop Relat Res 2008, 466:771-775.
• [3]Crowe JF, Mani VJ, Ranawat CS: Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 1979, 61:15-23.
• [4]Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N: Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 1996, 78:683-692.
• [5]Sanchez-Sotelo J, Berry DJ, Trousdale RT, Cabanela ME: Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options. J Am Acad Orthop Surg 2002, 10:334-344.
• [6]Rosenstein AD, Diaz RJ: Challenges and solutions for total hip arthroplasty in treatment of patients with symptomatic sequelae of developmental dysplasia of the hip. Am J Orthop (Belle Mead NJ) 2011, 40:87-91.
• [7]Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ: Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia. J Bone Joint Surg Am 2009, 91:2213-2221.
• [8]Dunn HK, Hess WE: Total hip reconstruction in chronically dislocated hips. J Bone Joint Surg Am 1976, 58:838-845.
• [9]Kilicoglu OI, Turker M, Akgul T, Yazicioglu O: Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation. J Arthroplasty 2013, 28:117-125.
• [10]Yang S, Cui Q: Total hip arthroplasty in developmental dysplasia of the hip: review of anatomy, techniques and outcomes. World J Orthop 2012, 3:42-48.
• [11]Zadeh HG, Hua J, Walker PS, Muirhead-Allwood SK: Uncemented total hip arthroplasty with subtrochanteric derotational osteotomy for severe femoral anteversion. J Arthroplasty 1999, 14:682-688.
• [12]Reikeras O, Haaland JE, Lereim P: Femoral shortening in total hip arthroplasty for high developmental dysplasia of the hip. Clin Orthop Relat Res 2010, 468:1949-1955.
• [13]Baz AB, Senol V, Akalin S, Kose O, Guler F, Turan A: Treatment of high hip dislocation with a cementless stem combined with a shortening osteotomy. Arch Orthop Trauma Surg 2012, 132:1481-1486.
• [14]Dallari D, Pignatti G, Stagni C, Giavaresi G, Del Piccolo N, Rani N, Veronesi F, Fini M: Total hip arthroplasty with shortening osteotomy in congenital major hip dislocation sequelae. Orthopedics 2011, 34:e328-e333.
• [15]Decking J, Decking R, Schoellner C, Fuerderer S, Rompe JD, Eckardt A: Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip. Arch Orthop Trauma Surg 2003, 123:357-362.
• [16]Becker DA, Gustilo RB: Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplasty 1995, 10:313-318.
• [17]Makita H, Inaba Y, Hirakawa K, Saito T: Results on total hip arthroplasties with femoral shortening for Crowe’s group IV dislocated hips. J Arthroplasty 2007, 22:32-38.
• [18]Strom L: Textbook of Pharmacoepidemiology. West Sussex: John Wiley & Sons; 2007.
• [19]Moher D, Liberati A, Tetzlaff J, Altman DG, Group P: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009, 339:b2535.
• [20]Freeman M, Tukey J: Transformations related to the angular and the square root. Ann Math Stats 1950, 21:607-611.
• [21]Higgins JP, Thompson SG: Quantifying heterogeneity in a meta-analysis. Stat Med 2002, 21:1539-1558.
• [22]Miller J: The inverse of the freeman-Tukey double arcsine transformation. Am Stat 1978, 32:138-138.
• [23]Higghins J, Green S: Cochrane Handbook for Systematic Reviews of Interventions. 2008.
• [24]Reikeraas O, Lereim P, Gabor I, Gunderson R, Bjerkreim I: Femoral shortening in total arthroplasty for completely dislocated hips: 3–7 year results in 25 cases. Acta Orthop Scand 1996, 67:33-36.
• [25]Gotze C, Winkelmann W, Gosheger G, Rodl R: Is there a need of an additional extramedullary fixation in transverse subtrochanteric shortening in primary total hip arthroplasty for patients with severe hip dysplasia? Short-term experience in seven patients with congenital dislocation. Z Orthop Unfall 2007, 145:568-573.
• [26]Howie CR, Ohly NE, Miller B: Cemented total hip arthroplasty with subtrochanteric osteotomy in dysplastic hips. Clin Orthop Relat Res 2010, 468:3240-3247.
• [27]Charity JA, Tsiridis E, Sheeraz A, Howell JR, Hubble MJ, Timperley AJ, Gie GA: Treatment of Crowe IV high hip dysplasia with total hip replacement using the Exeter stem and shortening derotational subtrochanteric osteotomy. J Bone Joint Surg Br 2011, 93:34-38.
• [28]Starker M, Bischof F, Lindenfeld T: Total hip arthroplasty with shortening subtrochanteric osteotomy and custom-made prosthesis in Crowe type IV developmental dysplasia. Z Orthop Unfall 2011, 149:518-525.
• [29]Semenowicz J, Szymanski S, Walo R, Czuma P, Pijet B: Total hip arthroplasty with shortening subtrochanteric Z osteotomy in the treatment of developmental dysplasia with high hip dislocation. Ortop Traumatol Rehabil 2012, 14:341-349.
• [30]Yasgur DJ, Stuchin SA, Adler EM, DiCesare PE: Subtrochanteric femoral shortening osteotomy in total hip arthroplasty for high-riding developmental dislocation of the hip. J Arthroplasty 1997, 12:880-888.
• [31]Chareancholvanich K, Becker DA, Gustilo RB: Treatment of congenital dislocated hip by arthroplasty with femoral shortening. Clin Orthop Relat Res 1999, 360:127-135.
• [32]Masonis JL, Patel JV, Miu A, Bourne RB, McCalden R, Macdonald SJ, Rorabeck CH: Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. J Arthroplasty 2003, 18:68-73.
• [33]Bernasek TL, Haidukewych GJ, Gustke KA, Hill O, Levering M: Total hip arthroplasty requiring subtrochanteric osteotomy for developmental hip dysplasia: 5- to 14-year results. J Arthroplasty 2007, 22:145-150.
• [34]Bruce WJ, Rizkallah SM, Kwon YM, Goldberg JA, Walsh WR: A new technique of subtrochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. J Arthroplasty 2000, 15:617-626.
• [35]Erdemli B, Yilmaz C, Atalar H, Guzel B, Cetin I: Total hip arthroplasty in developmental high dislocation of the hip. J Arthroplasty 2005, 20:1021-1028.
• [36]Ozturkmen Y, Karli M, Dogrul C: Cemented total hip arthroplasty for severe dysplasia or congenital dislocation of the hip. Acta Orthop Traumatol Turc 2002, 36:195-202.
• [37]Sener N, Tozun IR, Asik M: Femoral shortening and cementless arthroplasty in high congenital dislocation of the hip. J Arthroplasty 2002, 17:41-48.
• [38]Park MS, Kim KH, Jeong WC: Transverse subtrochanteric shortening osteotomy in primary total hip arthroplasty for patients with severe hip developmental dysplasia. J Arthroplasty 2007, 22:1031-1036.
• [39]Nagoya S, Kaya M, Sasaki M, Tateda K, Kosukegawa I, Yamashita T: Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip. J Bone Joint Surg Br 2009, 91:1142-1147.
• [40]Togrul E, Ozkan C, Kalaci A, Gulsen M: A new technique of subtrochanteric shortening in total hip replacement for Crowe type 3 to 4 dysplasia of the hip. J Arthroplasty 2010, 25:465-470.
• [41]Akiyama H, Kawanabe K, Yamamoto K, Kuroda Y, So K, Goto K, Nakamura T: Cemented total hip arthroplasty with subtrochanteric femoral shortening transverse osteotomy for severely dislocated hips: outcome with a 3- to 10-year follow-up period. J Orthop Sci 2011, 16:270-277.
• [42]Kilicarslan K, Yalcin N, Karatas F, Catma F, Yildirim H: Cementless total hip arthroplasty for dysplastic and dislocated hips. Eklem Hastalik Cerrahisi 2011, 22:8-15.
• [43]Takao M, Ohzono K, Nishii T, Miki H, Nakamura N, Sugano N: Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia. J Bone Joint Surg Am 2011, 93:548-555.
• [44]Zhong C, Cai XZ, Yan SG, He RX: S-ROM modular arthroplasty combined with transverse subtrochanteric shortening for Crowe type IV congenital dislocation of hip. Chin Med J (Engl) 2011, 124:3891-3895.
• [45]Hasegawa Y, Iwase T, Kanoh T, Seki T, Matsuoka A: Total hip arthroplasty for Crowe type developmental dysplasia. J Arthroplasty 2012, 27:1629-1635.
• [46]Sun QC, Wang XH, Song BS, Zhu FB, Yan SG: Total hip arthroplasty for crowe type IV developmental dysplasia of the hip with S-ROM prosthesis. Zhongguo Gu Shang 2013, 26:153-157.
• [47]Kawai T, Tanaka C, Ikenaga M, Kanoe H: Cemented total hip arthroplasty with transverse subtrochanteric shortening osteotomy for Crowe group IV dislocated hip. J Arthroplasty 2011, 26:229-235.
• [48]Li W, Zhang W, Bai G, Huang Z, Shen R: Total hip arthroplasty for treatment of Crowe type IV congenital dysplasia of hip with dislocation in adults. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013, 27:1153-1156.
• [49]Li Y, Ma W, Sun J, Song X, An M, Zhang Q: Becker V-shaped lateral rotation osteotomy in total hip arthroplasty for Crowe type IV development dislocation of hip. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013, 27:1032-1036.
• [50]Oe K, Iida H, Nakamura T, Okamoto N, Wada T: Subtrochanteric shortening osteotomy combined with cemented total hip arthroplasty for Crowe group IV hips. Arch Orthop Trauma Surg 2013, 133:1763-1770.
• [51]Oinuma K, Tamaki T, Miura Y, Kaneyama R, Shiratsuchi H: Total hip arthroplasty with subtrochanteric shortening osteotomy for Crowe grade 4 dysplasia using the direct anterior approach. J Arthroplasty 2014, 29:626-629.
• [52]Brooks PJ: Dislocation following total hip replacement: causes and cures. Bone Joint J 2013, 95-B:67-69.
• [53]Jamsen E, Varonen M, Huhtala H, Lehto MU, Lumio J, Konttinen YT, Moilanen T: Incidence of prosthetic joint infections after primary knee arthroplasty. J Arthroplasty 2010, 25:87-92.
• [54]Dale H, Hallan G, Hallan G, Espehaug B, Havelin LI, Engesaeter LB: Increasing risk of revision due to deep infection after hip arthroplasty. Acta Orthop 2009, 80:639-645.
• [55]Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J: Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res 2008, 466:1710-1715.
• [56]Harrison T, Robinson P, Cook A, Parker MJ: Factors affecting the incidence of deep wound infection after hip fracture surgery. J Bone Joint Surg Br 2012, 94:237-240.
• [57]Edwards C, Counsell A, Boulton C, Moran CG: Early infection after hip fracture surgery: risk factors, costs and outcome. J Bone Joint Surg Br 2008, 90:770-777.
• [58]Bracken J, Tran T, Ditchfield M: Developmental dysplasia of the hip: controversies and current concepts. J Paediatr Child Health 2012, 48:963-972. quiz 972–963