Total hip arthroplasty in patients with Paget’s disease of bone: A systematic review

Table 1 Demographics of the patients included in the studies and summary of the results

Study and country	No. of hips	Age (yr)	Follow-up (yr)	Type of fixation	Approach	Complications (implant related)	Heterotopic ossification (%)	Revision rate (%)	Functional outcome (pre and post op)
Merkow et al[11] 1984, United States	21	68.6 (57-80)	5.2 (2-11.4)	Cemented	Direct lateral (7) Antero-lateral (14)	Aseptic loosening (2)	52%	10%	HSS scale: 18 to 30
McDonald et al[12] 1987, United States	91	69.9 (49-85)	7.2 (0.7-15)	Cemented	Direct lateral (64) Antero-lateral (27)	Aseptic loosening (12) Deep infection (2) Instability (2) Foot drop (1) Nonunion of GT osteotomy (7)	37%	15%	HHS: 39 to 83
Ludkowski et al[13] 1990, United States	37	71.5 (60-81)	7.8 (1-18.4)	Cemented	Direct lateral	Superficial infection (3)	65%	0%	HHS: 48.1 to 83.2
Sochart et al[14] 2000, United Kingdom	98	67.4 (51-79)	10.4 (5.3-20)	Cemented	Direct lateral	Stem fracture (1) Deep infection (1) Instability (1) Aseptic loosening (2) Nonunion of GT osteotomy (1) Foot drop (1)	29%	5%
Kirsh et al[15] 2001, Australia	20	72 (62-82)	5.7 (4-8)	Uncemented (17) Hybrid (3)	Antero-lateral (13) Posterior (7)	Instability (1)	50%	0%	HHS: 31 to 88
Parvizi et al[16] 2002, United States	19	71.3 (54-85)	7 (2-15)	Uncemented	Posterior	Instability (1)	32%	0%	HHS: 59.8 to 86.7
Wegrzyn et al[17] 2010, France	39	74.2 (55-89)	6.6 (2-12)	Uncemented (36) Hybrid (3)	Antero-lateral (36) Posterior (3)	Intra-operative posterior column acetabular fracture (1) Periprosthetic fractures (2)	56%	0%	HHS: 54 to 89
Imbuldeniya et al[7] 2014, Australia	33	75 (63-85)	12.3 (10.3-17)	Uncemented	Posterior	Aseptic loosening/poly wear (4) Periprosthetic fracture (2)	45%	18%

HSS: Hospital for special surgery; HHS: Harris hip score.

Table 2 Comparison of the complication rates between the cemented and uncemented groups n (%)

Complication	Cemented THR (n = 247)	Uncemented THR (n = 105)
Aseptic loosening	16 (6)	3 (3)
Septic loosening	3 (1)	0 (0)
Periprosthetic fracture	0 (0)	4 (4)
Intra-operative fracture	0 (0)	1 (1)

THR: Total hip replacement.