Periacetabular osteotomy to treat hip dysplasia: a systematic review of harms and benefits.

Autor: Tønning, Lisa U., O'Brien, Michael, Semciw, Adam, Stewart, Christopher, Kemp, Joanne L., Mechlenburg, Inger
Předmět:
Zdroj: Archives of Orthopaedic & Trauma Surgery; Jun2023, Vol. 143 Issue 6, p3637-3648, 12p
Abstrakt: Introduction: Periacetabular osteotomy (PAO) is often performed in patients with hip dysplasia. The aim of this systematic review and meta-analysis was to evaluate the harms and benefits of PAO in patients with hip dysplasia in studies reporting both adverse events and patient-reported hip pain and function. Materials and methods: A systematic search combing PAO and patient-reported outcomes was performed in the databases MEDLINE, CINAHL, EMBASE, Sports Discuss and PsychINFO. Studies including both harms and benefits defined as adverse events and patient-reported hip pain and function were included. Risk of bias was assessed using The Cochrane Risk of Bias In Non-Randomized Studies – of Interventions. Results: Twenty-nine cohort studies were included, of which six studies included a comparison group. The majority of studies had serious risk of bias and the certainty of evidence was very low. The proportion of adverse events was 4.3 (95% CI 3.7; 4.9) for major adverse events and 14.0 (95% CI 13.0; 15.1) for minor adverse events. Peroneal nerve dysfunction was the most frequent adverse event among the major adverse events, followed by acetabular necrosis and delayed union or non-union. All patient-reported hip pain and function scores improved and exceeded the minimal clinically important differences after PAO. After 5 years, scores were still higher than the preoperative scores. Conclusion: PAO surgery has a 4% risk of major, and 14% risk of minor adverse events and a positive effect on patient-reported hip pain and function among patients with hip dysplasia. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index