The outcomes of total hip arthroplasty in developmental dysplasia of hip versus osteoarthritis: a systematic review and meta-analysis

Salman, Loay A.; Alzobi, Osama Z.; Al-Ani, Abdallah; Hantouly, Ashraf T.; Al-Juboori, Mohammed; Ahmed, Ghalib

doi:10.1007/s00590-023-03635-6

The outcomes of total hip arthroplasty in developmental dysplasia of hip versus osteoarthritis: a systematic review and meta-analysis

journal contribution

submitted on 2024-01-11, 09:28 and posted on 2024-01-15, 09:11 authored by Loay A. Salman, Osama Z. Alzobi, Abdallah Al-Ani, Ashraf T. Hantouly, Mohammed Al-Juboori, Ghalib Ahmed

Purpose

This systematic review and meta-analysis aimed to compare the outcomes of total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH) and those with osteoarthritis (OA).

Methods

Four databases were searched from inception till February 2023 for original studies that compared the outcomes of THA in DDH and OA. The primary outcome was the revision rate; the secondary outcomes were dislocation and failure modes (i.e. aseptic loosening, PJI, instability, and periprosthetic fractures), hospital stay and costs. This review was conducted as per PRISMA guidelines, and the risk of bias was assessed using the Newcastle–Ottawa scale.

Results

A total of 9 observational studies with 575,255 THA (469,224 hips) were included, with a mean age of 50.6 years and 62.1 years for DDH and OA groups, respectively. There was a statistically significant difference in revision rate between DDH and OA patients in favour of OA (OR, 1.66; 95% CI 1.11–2.48; p-value, 0.0251). However, dislocation rate (OR, 1.78, 95% CI 0.58–5.51; p-value, 0.200), aseptic loosening (OR, 1.69; 95% CI 0.26–10.84; p-value, 0.346) and PJI (OR, 0.76; 95% CI 0.56–1.03; p-value, 0.063) were comparable across both groups.

Conclusion

A higher revision rate following total hip arthroplasty was associated with DDH compared with osteoarthritis. However, both groups had similar dislocation rates, aseptic loosening and PJI. Consideration of confounding factors, such as patient age and activity level, is crucial when interpreting these findings.

Level of evidence

III.

Trial registration

PROSPERO registration: CRD42023396192.

Other Information

Published in: European Journal of Orthopaedic Surgery & Traumatology
License: https://creativecommons.org/licenses/by/4.0
See article on publisher's website: https://dx.doi.org/10.1007/s00590-023-03635-6

Additional institutions affiliated with: Surgical Specialty Center - HMC

Funding

Open Access funding provided by the Qatar National Library.

History

Language

English

Publisher

Springer Nature

Publication Year

2023

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

Hamad Medical Corporation
Hamad General Hospital - HMC

Methodology

Four databases were searched from inception till February 2023 for original studies that compared the outcomes of THA in DDH and OA. The primary outcome was the revision rate; the secondary outcomes were dislocation and failure modes (i.e. aseptic loosening, PJI, instability, and periprosthetic fractures), hospital stay and costs. This review was conducted as per PRISMA guidelines, and the risk of bias was assessed using the Newcastle–Ottawa scale.