Lisa U Tønning1,2, Michael O'Brien3, Adam Semciw4,5, Christopher Stewart3, Joanne L Kemp3,5, Inger Mechlenburg6,7,8. 1. Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. lisatoenning@clin.au.dk. 2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark. lisatoenning@clin.au.dk. 3. La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia. 4. Northern Centre for Health Education and Research, 185 Cooper St, Epping, VIC, 3076, Australia. 5. Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, 240 Plenty Rd, Bundoora, VIC, 3083, Australia. 6. Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. 7. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark. 8. Department of Public Health - Sport and Body Culture, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
Abstract
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.
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.
Authors: John C Clohisy; Amanda L Schutz; Lauren St John; Perry L Schoenecker; Rick W Wright Journal: Clin Orthop Relat Res Date: 2009-04-21 Impact factor: 4.176
Authors: Jeffrey J Nepple; Joel Wells; James R Ross; Asheesh Bedi; Perry L Schoenecker; John C Clohisy Journal: Clin Orthop Relat Res Date: 2017-04 Impact factor: 4.176