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Total hip arthroplasty after pelvic osteotomy: a meta-analysis
Acta Orthopaedica Belgica
|January 24, 2025
Summary
Total hip arthroplasty following pelvic osteotomy leads to longer operative times, increased blood loss, and poorer functional scores compared to primary total hip arthroplasty. Preoperative imaging is recommended due to altered anatomy after pelvic osteotomy.
Area of Science:
- Orthopedic surgery
- Reconstructive surgery
Background:
- Previous pelvic osteotomy (PO) may complicate total hip arthroplasty (THA).
- Contradictory findings exist regarding the outcomes of THA after PO versus primary THA.
Purpose of the Study:
- To compare clinical outcomes and parameters between THA following PO and primary THA through a meta-analysis.
Main Methods:
- Systematic literature search of multiple databases (PubMed, Cochrane, EMBASE, etc.) up to September 2020.
- Inclusion of 14 studies with 3913 participants.
- Comparison of operative time, blood loss, Harris hip score (HHS), revision/complication rates, cup position, and hip joint center.
Main Results:
- THA after PO showed longer operative time, greater blood loss, and worse HHS.
- Acetabular component positioning was affected, with smaller anteversion, larger cup size, and more lateral/superior hip joint center.
- No significant differences in revision rates, complication rates, acetabular abduction angle, or cup coverage were found.
Conclusions:
- THA after PO is associated with inferior intraoperative outcomes, lower functional scores, and poorer acetabular component positioning.
- Altered anatomy post-PO necessitates thorough preoperative assessment, including CT scans, for optimal THA results.
