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

BMC Musculoskeletal Disorders

Research Article

Changchuan Li¹  Chi Zhang¹  Maolin Zhang¹  Yue Ding¹ 

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

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

DOI  :  10.1186/1471-2474-15-331

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

来源: Springer

【 摘 要 】

BackgroundSubtrochanteric 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.MethodsWe 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.ResultsMeta-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.ConclusionsTransverse 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】

Unknown   
© Li et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.