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

Autor: Lisa U. Tønning, Michael O’Brien, Adam Semciw, Christopher Stewart, Joanne L. Kemp, Inger Mechlenburg
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Tønning, L U, O'Brien, M, Semciw, A, Stewart, C, Kemp, J L & Mechlenburg, I 2023, ' Periacetabular osteotomy to treat hip dysplasia : a systematic review of harms and benefits ', Archives of Orthopaedic and Trauma Surgery, vol. 143, no. 6, pp. 3637-3648 . https://doi.org/10.1007/s00402-022-04627-7
DOI: 10.1007/s00402-022-04627-7
Popis: 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.
Databáze: OpenAIRE