Background
Methods
Variable | Answer options |
---|---|
Date of birth | |
Date of surgery | |
Gender | male |
female | |
Operation side | right |
left | |
Diagnosis | osteoarthritis |
developmental displasia | |
inflammatory arthritis | |
fracture | |
miscellaneous | |
Pain | none |
mild | |
moderate | |
severe | |
intolerable | |
Walking capacity restriction | >60 min |
31 min to 60 min | |
10 min to 30 min | |
<10 min | |
impossible | |
Flexion | >90° |
71° to 90° | |
30° to 70° | |
<30° | |
stiff | |
Harris Hip Score | |
Intraoperative complications | none |
perforation | |
proximal fracture | |
distal fracture | |
fracture of trochanter | |
tendency to dislocate | |
vascular | |
pelvic perforation | |
other | |
Systemic postoperative complication | none |
deep thrombosis | |
pulmonary embolism | |
cardiovascular | |
respiratory | |
gastrointestinal | |
urological | |
CNS | |
other | |
Local postoperative complication | none |
hematoma | |
dislocation | |
neuropraxia | |
wound dehiscence | |
superficial | |
deep infection | |
sinus | |
other | |
Follow-up date |
Sample characteristics
Statistical analysis
Literature review
Results
Number of patients | Age | Proportion of women | Treated between (ys) | 80% of treatments performed between (ys) | ||
---|---|---|---|---|---|---|
Range | Mean | |||||
Group I | 247 | 22-85 | 59 | 53% | 1978-2001 | 1989-1999 |
Group II | 737 | 20-88 | 62 | 50% | 1968-2002 | 1984-1999 |
Group III | 835 | 22-87 | 63 | 49% | 1980-1998 | 1984-1994 |
Reference group (unilateral) | 8402 | 20-94 | 65 | 51% | 1982-2000 | 1985-1998 |
Comparison of groups - preoperative status
Group I: 247 | Group II: 737 | Group III: 835 | Group IV: 8402 | |||||
---|---|---|---|---|---|---|---|---|
Diagnosis | n | % | n | % | n | % | n | % |
Osteoarthritis | 173 |
70.0
| 532 |
72.2
| 663 |
79.4
| 6391 |
76.1
|
Dysplasy | 43 |
17.4
| 99 |
13.4
| 85 |
10.2
| 665 |
7.9
|
Inflammation | 15 |
6.1
| 40 |
5.4
| 25 |
3.0
| 103 |
1.2
|
Fracture | 1 |
0.4
| 9 |
1.2
| 6 |
0.7
| 689 |
8.2
|
Miscellaneous | 15 |
6.1
| 57 |
7.7
| 56 |
6.7
| 554 |
6.6
|
Group I: 247 | Group II: 737 | Group III: 835 | |
---|---|---|---|
Pain | |||
none/mild | 6% | 4% | 2% |
moderate | 34% | 26% | 31% |
severe/intolerable |
60%
|
70%
|
67%
|
Walking capacity
| |||
>60 min | 11% | 6% | 5% |
31 min to 60 min | 18% | 11% | 14% |
10 min to 30 min | 26% | 18% | 17% |
<10 min/impossible |
45%
|
65%
|
64%
|
Flexion
| |||
>90° | 19% | 9% | 14% |
71° to 90° | 39% | 42% | 48% |
30° to 70° | 31% | 36% | 31% |
<30°/stiff |
11%
|
13%
|
7%
|
Comparison of groups - outcome
Comparison of groups - complications
OP1 | OP2 | OP1 + OP2 | |||||||
---|---|---|---|---|---|---|---|---|---|
IntaOP complications | Group I | Group II | Group III | Group I | Group II | Group III | Group I | Group II | Group III |
shaft perforation | - | 1 | 2 | 1 | - | 2 | 1 | 1 | 4 |
proximal Fx | 2 | 4 | 9 | - | 2 | 9 | 2 | 6 | 18 |
Fx of trochanter | 4 | 13 | 16 | 10 | 13 | 21 | 14 | 26 | 37 |
tendency for luxation | - | 7 | 9 | 4 | 10 | 5 | 4 | 17 | 14 |
vascular injury | - | - | 2 | - | - | 1 | - | - | 3 |
pelvic perforation | - | 9 | 6 | 1 | 4 | 4 | 1 | 13 | 10 |
other | 2 | 6 | 3 | 1 | 2 | 6 | 3 | 8 | 9 |
total %
|
3.2
|
5.4
|
5.5
|
6.9
|
4.2
|
5.6
|
10.1
|
9.6
|
11.1
|
Systemic complications
|
Group I
|
Group II
|
Group III
|
Group I
|
Group II
|
Group III
|
Group I
|
Group II
|
Group III
|
deep thrombosis | - | 6 | 16 | 1 | 5 | - | 7 | 21 | |
pulmonary emboly | 1 | 6 | 6 | 4 | 3 | 1 | 10 | 9 | |
cardiovascular | 3 | 5 | 14 | 6 | 17 | 3 | 11 | 31 | |
respiratory | - | 7 | 8 | 1 | 3 | - | 8 | 11 | |
gastrointestinal | 3 | 13 | 13 | 8 | 9 | 3 | 21 | 22 | |
urological | 11 | 12 | 25 | 14 | 16 | 11 | 26 | 41 | |
CNS | - | 3 | 5 | 3 | 5 | - | 6 | 10 | |
other | 8 | 6 | 5 | 7 | 8 | 8 | 13 | 13 | |
total %
|
10.5
|
7.9
|
10.8
|
6.0
|
7.7
|
10.5
|
13.8
|
18.5
| |
Local complications
|
Group I
|
Group II
|
Group III
|
Group I
|
Group II
|
Group III
|
Group I
|
Group II
|
Group III
|
haematoma | 11 | 38 | 44 | 12 | 34 | 49 | 23 | 72 | 93 |
dislocation | 1 | 2 | 4 | 3 | 5 | 5 | 4 | 7 | 9 |
neuropraxia | - | 2 | 7 | 1 | 4 | 7 | 1 | 6 | 14 |
wound dehiscence | - | 5 | 2 | - | 1 | 5 | - | 6 | 7 |
total %
|
4.9
|
6.4
|
6.7
|
6.5
|
6.0
|
7.7
|
11.4
|
12.4
|
14.4
|
Discussion
N | Authors | Year | Period | Study | Number of pat. | Inter-operative days | FU (months) | Functional outcome | Complications | Pro/contra |
---|---|---|---|---|---|---|---|---|---|---|
1 | Alfaro-Adriàn | 1999 | 1989-95 | 1/2 stage | 202(95/107) | 0/60-730(300) | 0 | similar | >blood transfusions | pro: <hospital stay, costs |
2 | Berend KR | 2007 | 1997-05 | 1/2 stage | 277(167/110) | 0/14-730(240) | 30(6-108) | early: <function | >blood transfusions >revisions | contra: <reimbursement |
3 | Bhan | 2006 | 1996-01 | 1/2 stage | 168(83/85) | 0/90-210 | 60(48-96) | similar | >blood transfusions | pro: < hospital stay |
4 | Eggli | 1996 | 1982-92 | 1/2 stage | 255(64/63/128) | 0/>42/42-180 | >18 | similar; >stiff hip | similar | pro: <hospital stay, costs |
5 | McBryde | 2007 | 1994-06 | 1/2 stage | 92(37/55) | 0/1-365 | 15(1-60)/34(1-131) | early better | similar, >intubation time | pro: <hospital stay, costs |
6 | Parvizi | 2006 | 1997-04 | 1/2 stage | 196(98/98) | 0/25-303(138) | 0 | similar | <blood transfusions <complications | pro: <costs, >rehabilitation |
7 | Reuben | 1998 | 1991-94 | 1/2 stage/unilat | 154(7/8/139) | 0/7/unilat | 0 | - | - | pro: < costs |
8 | Salvati | 1978 | 1970-76 | 1/2 stage | 461(122/134/205) | 0/same hosp/2nd hosp | 36(12-96) | similar | similar | pro: <hospital stay, costs, OP time |
9 | Schiessel | 2005 | 1996-02 | 1/2 stage | 30(15/15) | 0/120-665(485) | 66(SD 19.5) | similar (subjectively>) | similar | pro: <hospital stay, costs |
10 | Shih | 1985 | 1979-82 | 1/2 stage | 35(20/15) | 0/14-365 | 12/17.7 | similar but <ROM | similar | pro: <hospital stay, OP time |