Systematic Review of Total Hip Arthroplasty Outcomes in Cerebral Palsy Patients and a Comparative Analysis with Rheumatoid Arthritis

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-12-30 DOI:10.1155/2023/8696116

Christos Costa, F. Moniati, M. Chatzimatthaiou, Christos Papaioannou, Sapfo Athanasakopoulou, Marios Chatzimatthaiou

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引用次数: 0

Abstract

Background. Total hip arthroplasty (THA) is considered a successful treatment option for patients with degenerative hip arthritis. However, in the setting of neuromuscular diseases, patients with cerebral palsy (CP) are considered high-risk due to instability, contractures, and altered muscle tone. The purpose of this systematic review is to analyse the data in the setting of THA in CP patients including indications, types of implants, revision rates, and patient-reported outcomes and compare these with those of a cohort requiring THA due to degenerative arthritis unrelated to neuromuscular disorders. Methods. PubMed, Embase, and Cochrane Library were searched from inception until June 10, 2023, to identify the relevant studies for THA on CP patients. The methodological quality of the studies was evaluated using the Newcastle–Ottawa Quality Assessment Scale (NOS). Results. The initial search generated 190 studies out of which 21 met the inclusion criteria. The most frequently reported indication was painful hip dislocation or subluxation due to failure of prior nonoperative treatment. The most frequently reported complication was dislocation affecting overall 7.5% (0–28%) of all patients, while other complications included periprosthetic fractures and heterotrophic ossification. The survival rates of primary THAs ranged from 85% to 100% at 5 years and from 73% to 86% at 10 years. Patients with CP who undergo total hip arthroplasty experience a greater overall rate of complications compared to patients with rheumatoid arthritis (RA) that undergo the same procedure. Conclusion. The current literature suggests that THA is a beneficial procedure for patients with CP through pain reduction and functional improvement. However, the increased rates of potential complications compared to the general population require careful consideration. We suggest that further investigations on the most appropriate time of procedure, implant type, and procedure are needed.

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脑瘫患者全髋关节置换术效果的系统回顾以及与类风湿关节炎的比较分析

背景。全髋关节置换术（THA）被认为是退行性髋关节炎患者的成功治疗方案。然而，在神经肌肉疾病方面，脑性麻痹（CP）患者因其不稳定性、挛缩和肌张力改变而被视为高危人群。本系统性综述的目的是分析 CP 患者髋关节置换术的相关数据，包括适应症、植入物类型、翻修率和患者报告的结果，并将这些数据与因与神经肌肉疾病无关的退行性关节炎而需要髋关节置换术的患者进行比较。方法。对 PubMed、Embase 和 Cochrane 图书馆进行了检索，检索时间从开始到 2023 年 6 月 10 日，以确定有关 CP 患者 THA 的相关研究。研究的方法学质量采用纽卡斯尔-渥太华质量评估量表（NOS）进行评估。结果。最初的搜索共收集到 190 项研究，其中 21 项符合纳入标准。最常报道的适应症是由于之前的非手术治疗失败导致的疼痛性髋关节脱位或半脱位。最常见的并发症是脱位，占所有患者的 7.5%（0-28%），其他并发症包括假体周围骨折和异养骨化。初级全髋关节置换术的 5 年存活率为 85% 至 100%，10 年存活率为 73% 至 86%。与类风湿性关节炎（RA）患者相比，接受全髋关节置换术的CP患者的总体并发症发生率更高。结论。目前的文献表明，全髋关节置换术可减轻疼痛并改善功能，对 CP 患者有益。然而，与普通人群相比，潜在并发症的发生率有所增加，这需要慎重考虑。我们建议需要进一步研究最合适的手术时间、植入物类型和手术方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.