A Meta-analysis Different Reconstruction Methods Of Acetabulum In The Primary Hip Arthroplasty With Development Displasia Hip

Development displasia hip is a common disease of hip joint. A part of mild patients could be asymptomatic in childhood, and be diagnosed at young for consulting about secondary arthritics. DDH had strong impact on life qualities of patients by resulting in irreversible painful osteoarthritis and varying degrees physical disability. Their acetabulum and proximal femur are dysplasia, femur head had a superior dislocation, proximal femur covers the true acetabularm. With varying degrees of bone defect, acetabulum is full of osteotylus and cicatrice. Acetabulum deformity is complex as well as various. The efficiency of routine hip arthroplasty is not satisfactory. So the management of acetabulum is important for patients with hip arthroplasty. It is controversial on methods of acetbulum to reconstruction the hip. Objective:To evaluate clinical therapeutic effect of different reconstruction methods of acetabulum in the primary hip arthroplasty with development displasia and provide evidences of evidence-based medicine.Methods: We collect randomized controlled trials(RCT) and semi-random controlled trials from the following data sources(The deadline on December 31, 2014). Pubmed, Science direct, The Cochran Library, Springer, Wiley Inter-science, CNKI, wanfang. Evaluate the quality of all studies. Use the Review Manager 5.3 software provided by Cochran Collaboration to analyze the date. Use standard mean difference(SMD) to count continuous variables, odds ratio(OR)to count two categorical variables. Results: Five studies were included in this study. Meta-analysis showed that : in comparison of anatomy hip center and high hip center, no significant difference in Harris Scales[ MD = 1.58,95% CI(-10.98,14.14),P =0. 81], revise rates [OR =0. 99,95% CI( 0. 20,4. 99),P = 0. 99], dislocation rates[OR =0.37,95%CI( 0.07,1.88),P =0.23], fracture[OR = 0.39,95% CI( 0.05,3.24),P =0.39], wear rates[MD =-0.00,95% CI(-0.02,0.02),P =0.72]. In the comparison of structural bone graft and acetabulum centralize,no significant difference in revise rates[OR =0. 96,95% CI( 0.07,13.37),P = 0. 98], loose r a t e s [ O R = 0. 6 3, 9 5 % C I( 0. 2 3, 1. 6 9), P = 0. 3 6 ].Conclusion:Results of the Meta analysis indicated that two types of recon struction(anatomy hip center and high hip center)showed good effect on post-surgery pain relief, deformity correction, and function improvement. Both of them are good ways for total hip acetabulum reconstruction. Significant difference was not observed in revise rates, dislocation rates, fracture,wear rates. Conventional structural bone grafting and hip joint center were both good types of total hip acetabulum reconstruction. Significant difference was not observed in limited data.