Risk Factors for Dislocation Following Total Hip Arthroplasty in Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2023 Sep 9

PMID 37688602

Authors

Parmida Shahbazi

Amir Hossein Jalilvand

Amirhossein Ghaseminejad-Raeini

Ali Ghaderi

Mehrdad Sheikhvatan

Yousef Fallah

Seyyed Hossein Shafiei

Affiliations

Soon will be listed here.

Abstract

Purpose: This systematic review and meta-analysis aimed to identify risk factors of dislocation after total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH).

Methods: A systematic literature review was performed on 18th August 2022 using Medline, Embase, Scopus, Web of Science electronic databases, and a manual search. The study was conducted according to the PRISMA guidelines and registered with PROSPERO. Statistical analysis includes assessment of heterogeneity and data synthesis using RevMan 5.4.

Results: Review of five studies including 2865 patients and 116 dislocated hips found that lower body mass index (BMI) (SMD = 0.22, p = 0.04, I = 0%), Crowe classification type IV versus I, II, and III (OR = 2.70, p = 0.004, I = 51%), higher cup inclination (SMD = 0.39 p = 0.0007, I = 0%), femoral head size < 28 mm (OR = 5.07, p = 0.003, I = 71%), lateral surgical approach (OR = 1.96, p = 0.02, I = 0%), and postoperative infection (OR = 6.26, p < 0.0001, I = 0%) were significant risk factors. However, age, gender, cup anteversion, femoral osteotomy, vertical (V-COR) centre of rotation, intraoperative fracture, preoperative and postoperative leg length discrepancy (LLD) and previous hip surgery were not found to be significant risk factors.

Conclusion: This study underscores importance of these risk factors in THA planning for DDH patients to reduce dislocation risk. Further research needed to understand mechanisms.

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