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The outcomes of total hip replacement in osteonecrosis versus osteoarthritis: a systematic review and meta-analysis

journal contribution
submitted on 2024-01-11, 07:12 and posted on 2024-01-15, 05:33 authored by Loay A. Salman, Ashraf T. Hantouly, Harman Khatkar, Abdallah Al-Ani, Abedallah Abudalou, Mohammed Al-Juboori, Ghalib Ahmed

Purpose

This systematic review and meta-analysis aimed to compare the outcomes of THA in patients with osteonecrosis (ON) and those with osteoarthritis (OA).

Methods

Four databases were searched from inception till December 2022 for original studies that compared the outcomes of THA in ON and OA. The primary outcome was the revision rate; the secondary outcomes were dislocation and Harris hip score. This review was conducted in line with PRISMA guidelines, and the risk of bias was assessed using the Newcastle–Ottawa scale.

Results

A total of 14 observational studies with 2,111,102 hips were included, with a mean age of 50.83 ± 9.32 and 55.51 ± 8.95 for ON and OA groups, respectively. The average follow-up was 7.25 ± 4.6 years. There was a statistically significant difference in revision rate between ON and OA patients in favour of OA (OR: 1.576; 95%CI: 1.24–2.00; p-value: 0.0015). However, dislocation rate (OR: 1.5004; 95%CI: 0.92–2.43; p-value: 0.0916) and Haris hip score (HHS) (SMD: − 0.0486; 95%CI: − 0.35–0.25; p-value: 0.6987) were comparable across both groups. Further sub-analysis adjusting for registry data also showed similar results between both groups.

Conclusion

A higher revision rate, periprosthetic fracture and periprosthetic joint infection following total hip arthroplasty were associated with osteonecrosis of the femoral head compared with osteoarthritis. However, both groups had similar dislocation rates and functional outcome measures. This finding should be applied in context due to potential confounding factors, including patient’s age and activity level.

Other Information

Published in: International Orthopaedics
License: https://creativecommons.org/licenses/by/4.0
See article on publisher's website: https://dx.doi.org/10.1007/s00264-023-05761-6

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 December 2022 for original studies that compared the outcomes of THA in ON and OA. The primary outcome was the revision rate; the secondary outcomes were dislocation and Harris hip score. This review was conducted in line with PRISMA guidelines, and the risk of bias was assessed using the Newcastle–Ottawa scale.

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