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Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review

BACKGROUND: As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, i...

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Autores principales: O’Driscoll, Conor S., Hughes, Andrew J., Davey, Martin S., Queally, Joseph M., O’Daly, Brendan J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768244/
https://www.ncbi.nlm.nih.gov/pubmed/36568851
http://dx.doi.org/10.1016/j.artd.2022.11.001
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author O’Driscoll, Conor S.
Hughes, Andrew J.
Davey, Martin S.
Queally, Joseph M.
O’Daly, Brendan J.
author_facet O’Driscoll, Conor S.
Hughes, Andrew J.
Davey, Martin S.
Queally, Joseph M.
O’Daly, Brendan J.
author_sort O’Driscoll, Conor S.
collection PubMed
description BACKGROUND: As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, instability, and altered muscular tone. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival following THA for patients with neurological conditions affecting the hip. Thus, we aim to support orthopaedic surgeon decision-making when considering and planning THA for these patients. METHODS: A systematic review was performed as per Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using the PubMed/Medline OVID, Cochrane, and Embase databases. All studies reporting the outcomes of THA in the neurological population which met defined inclusion criteria were included. RESULTS: From an initial screen of 1820 studies, 45 studies with a total of 36,251 THAs were included in the final selection. All 45 studies reported complication rates, with controls included in 16 for comparison. High complication rates were observed following THA in the neurologically impaired population, most notably dislocation with observed rates up to 10.6%. An improvement was noted in all 36 studies (1811 THAs) which reported upon patient-reported outcomes. CONCLUSIONS: THA may be beneficial in the selected patients with neurological conditions, to reduce pain and improve function. There is an increased risk of complications which require careful consideration when planning the operation and open discussion with prospective patients and caregivers before proceeding with surgery.
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spelling pubmed-97682442022-12-22 Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review O’Driscoll, Conor S. Hughes, Andrew J. Davey, Martin S. Queally, Joseph M. O’Daly, Brendan J. Arthroplast Today Systematic Review BACKGROUND: As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, instability, and altered muscular tone. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival following THA for patients with neurological conditions affecting the hip. Thus, we aim to support orthopaedic surgeon decision-making when considering and planning THA for these patients. METHODS: A systematic review was performed as per Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using the PubMed/Medline OVID, Cochrane, and Embase databases. All studies reporting the outcomes of THA in the neurological population which met defined inclusion criteria were included. RESULTS: From an initial screen of 1820 studies, 45 studies with a total of 36,251 THAs were included in the final selection. All 45 studies reported complication rates, with controls included in 16 for comparison. High complication rates were observed following THA in the neurologically impaired population, most notably dislocation with observed rates up to 10.6%. An improvement was noted in all 36 studies (1811 THAs) which reported upon patient-reported outcomes. CONCLUSIONS: THA may be beneficial in the selected patients with neurological conditions, to reduce pain and improve function. There is an increased risk of complications which require careful consideration when planning the operation and open discussion with prospective patients and caregivers before proceeding with surgery. Elsevier 2022-12-12 /pmc/articles/PMC9768244/ /pubmed/36568851 http://dx.doi.org/10.1016/j.artd.2022.11.001 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Systematic Review
O’Driscoll, Conor S.
Hughes, Andrew J.
Davey, Martin S.
Queally, Joseph M.
O’Daly, Brendan J.
Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review
title Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review
title_full Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review
title_fullStr Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review
title_full_unstemmed Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review
title_short Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review
title_sort total hip arthroplasty in patients with neurological conditions: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768244/
https://www.ncbi.nlm.nih.gov/pubmed/36568851
http://dx.doi.org/10.1016/j.artd.2022.11.001
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