Incidence and complication rate of arthroplasty in Perthes disease management: A systematic review and meta-analysis

Background: Perthes disease presents a challenge in orthopedic management, often necessitating surgical intervention such as arthroplasty. This meta-analysis systematically evaluated the rate of occurrence and complications associated with arthroplasty in Perthes disease.

Methods: A comprehensive search was conducted across PubMed, Web of Sciences, Scopus, and Cochrane Library databases to identify relevant studies. Inclusion criteria encompassed studies evaluating arthroplasty outcomes in patients with Perthes disease. Data extraction and quality assessment were performed independently by two reviewers. Results were synthesized using random effects models, and heterogeneity was assessed using I² statistics. Twenty-eight observational studies were included with a total of 1737 patients, reporting moderate heterogeneity.

Results: We found that the incidence of arthroplasty among the 18 studies included in the meta-analysis was 7 % (95 % confidence interval [CI]: 0.045-0.95, I² = 58 %). Complications following arthroplasty were significant with an incidence of 22.9 % among 283 patients. In summary, an analysis of 30 observational studies found a 7 % incidence of arthroplasty with complications following surgery affecting nearly 23 % of patients.

Conclusion: The results of this study suggest that arthroplasty is a relatively uncommon procedure for Perthes disease management. Complications following arthroplasty are a significant concern, affecting nearly one-quarter of patients. Although the use of arthroplasty in Perthes is uncommon, the rate of complications has raised concerns, indicating its use is relatively unsafe. Therefore, in patients with Perthes disease who undergo arthroplasty, attention should be given to the risk of complications, and preventive measures need to be investigated to overcome this risk.

Type of study: Systematic review and meta-analysis.

Level of evidence: II.