Long-term outcomes of the hip shelf arthroplasty in adolescents and adults with residual hip dysplasia a systematic review

摘要

Background and purpose — The shelf arthroplasty wasthe regular treatment for residual hip dysplasia before it wassubstituted by the peri-acetabular osteotomy. Yet, evidenceregarding the survival of shelf arthroplasty surgery has neverbeen systematically documented. Hence, we investigated thesurvival time of the shelf procedure until revision to THA inpatients with primary hip dysplasia. Factors that influencedsurvival and complications were also examined, along withthe accuracy of correcting radiographic parameters to char-acterize dysplasia.Material and methods — The inclusion criteria werestudies of human adolescents and adults (> 16 years) withprimary or congenital hip dysplasia who were treated with ashelf arthroplasty procedure. Data were extracted concerningpatient characteristics, survival time, complications, opera-tive techniques, and accuracy of correcting radiographicparameters.Results — Our inclusion criteria were applicable to 9studies. The average postoperative Center-Edge Angle andAcetabular Head Index were mostly within target range, butlarge variations were common. Kaplan–Meier curves (end-point: conversion to THA) varied between 37% at 20 years’follow-up and 72% at 35 years’ follow-up. Clinical fail-ures were commonly associated with pain and radiographicosteoarthritis. Only minor complications were reported withincidences between 17% and 32%.Interpretation — The shelf arthroplasty is capable ofrestoring normal radiographic hip parameters and is not asso-ciated with major complications. When carefully selected onminimal osteoarthritic changes, hip dysplasia patients with aclosed triradiate cartilage may benefit from the shelf proce-dure with satisfactory survival rates. The importance of theshelf arthroplasty in relation to peri-acetabular osteotomiesneeds to be further (re)explored.