Prothèse totale de hanche après ostéotomie pelvienne préalable : revue systématique et méta-analyse

Background There are several reports regarding total hip arthroplasty (THA) after a previous pelvic osteotomy (PO). However, to our knowledge, until now there has been no formal systematic review and meta-analysis published to summarize the clinical results of THA after a previous PO. Therefore, we conducted a systematic review and meta-analysis of results of THA after a previous PO. We focus on these questions as follows: does a previous PO affect the results of subsequent THA, such as clinical outcomes, operative time, operative blood loss, and radiological parameters. Methods Using PubMed, Web of Science, and Cochrane Library, we searched for relevant original papers. The pooling of data was performed using RevMan software (version 5.3, Cochrane Collaboration, Oxford, UK). A p-value 50%, significant heterogeneity was assumed and a random-effects model was applied for the meta-analysis. A fixed-effects model was applied in the absence of significant heterogeneity. Results Eleven studies were included in this meta-analysis. The pooled results indicated that there was no significant difference in postoperative Merle D’Aubigne-Postel score (I2 = 0%, SMD = −0.15, 95% CI: −0.36 to 0.06, p = 0.17), postoperative Harris hip score (I2 = 60%, SMD = −0.23, 95% CI: −0.50 to 0.05, p = 0.10), operative time (I2 = 86%, SMD = 0.37, 95% CI: −0.09 to 0.82, p = 0.11), operative blood loss (I2 = 82%, SMD = 0.23, 95% CI: −0.17 to 0.63, p = 0.25), and cup abduction angle (I2 = 43%, SMD = −0.08, 95% CI: −0.25 to 0.09, p = 0.38) between THA with and without a previous PO. However, cup anteversion angle of THA with a previous PO was significantly smaller than that of without a previous PO (I2 = 77%, SMD = −0.63, 95% CI: −1.13 to −0.13, p = 0.01). Conclusion Systematic review and meta-analysis of results of THA after a previous PO was performed. A previous PO did not affect the results of subsequent THA, except for cup anteversion. Because of the low quality evidence currently available, high-quality randomized controlled trials are required. Level of evidence Level III, meta-analysis of case control studies.