Outcomes of Total Joint Arthroplasty in Patients Who Have Ehlers-Danlos Syndrome: A Systematic Review and Meta-Analysis
Abstract
BACKGROUND
Patients who have Ehlers-Danlos Syndrome (EDS), a group of connective tissue disorders characterized by aberrant collagen synthesis and processing, have an increased likelihood of requiring a total joint arthroplasty (TJA), including total hip or knee arthroplasty (THA or TKA). This study aimed to synthesize outcomes following TJA in patients who have EDS.
METHODS
This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that described outcomes of TJA in EDS patients were searched from PubMed, Medline, The Cochrane Library, and Embase. Case series and cohort studies were included if they identified patients who had EDS who underwent either primary THA or TKA. Rates of reoperation and/or revision, instability or frank dislocation, aseptic loosening, periprosthetic fractures, periprosthetic joint infection (PJI), medical complications, wound complications, and readmissions were collected and compared to patients who do not have EDS undergoing TJA for osteoarthritis when available. Individual pooled comparative meta-analysis was performed for each variable. Patient-reported outcome measures (PROMs) were collected and qualitatively described. The search yielded eight publications with 1,769 EDS patients (1,011 THA and 758 TKA) describing outcomes after TJA, seven of which were included in the meta-analysis.
RESULTS
Following THA, EDS patients were at increased risk of all-cause revision (OR [odds ratio] =…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,769 participants or records.
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