Evidence map›Paper›PMID 41026223›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Total HIP arthroplasty following pelvic irradiation: a systematic review focusing on the last two decades.

Giuseppe Francesco Papalia, Biagio Zampogna, Andrea Zampoli, Clemente Caria, Antonino De Rosa, Pierangelo Za, Michele Paciotti, Michele Fiore, Sergio Ramella, Rocco Papalia

Erratum issuedAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Giuseppe Francesco PapaliaDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Biagio ZampognaDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Andrea ZampoliDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Clemente CariaDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy. clemente.caria@unicampus.it.
Antonino De RosaDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Pierangelo ZaDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Michele PaciottiDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Michele FioreDepartment of Radiation Oncology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, 21-00128, Italy.
Sergio RamellaDepartment of Radiation Oncology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, 21-00128, Italy.
Rocco PapaliaDepartment of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRadiation therapy (RT) is a standard treatment for primitive and metastatic cancers. However, it may cause adverse effects on organs and bones surrounding the target volumes. Therefore, patients with prior pelvic RT pose challenges for total hip arthroplasty (THA). This study aims to summarize the evidence on THA outcomes in this population, focusing on patient-reported measures (PROMs), revision rates, and complications.

methodsA systematic literature review was conducted in October 2024 by two authors following the PRISMA guidelines on PubMed, Scopus, and Cochrane databases. RT indication, radiation dose, interval between RT and THA, specific surgical indications, implant types, postoperative PROMs, and perioperative complications were extracted and analyzed. The risk of bias was assessed through the Methodological Index for Non-Randomized Studies (MINORS) score.

resultsNine articles were included, comprising 2788 patients with a mean age of 65.5 years (ranging from 19 to 90 years) who underwent pelvic irradiation for various malignancies. The average radiation dose was 5755 cGy over a 60-month follow-up period. Avascular osteonecrosis of the femoral head was the primary indication for THA. The median time between RT and THA was 6 years. The overall complication rate was 5.9% and occurred on average 60 months after surgery. Aseptic loosening and septic complications were the most common causes of failure. Across the study reporting the Harris Hip Score, the pooled mean values improved from 44.2 preoperative to 83.7 postoperatively. DISCUSSION: Performing THA in patients with previous pelvic RT carries an increased risk of complications and early failure due to compromised bone quality, reduced osseointegration capacity, and weakened immune response. Therefore, technology advancements, including tantalum or porous titanium implants and targeted antibiotic prophylaxis, may benefit this high-risk population.

Indexed as

Arthroplasty, Replacement, HipFemur Head NecrosisAdultAgedFemaleHip ProsthesisHumansMaleMiddle AgedPatient Reported Outcome MeasuresPelvic BonesPelvisPostoperative ComplicationsReoperationClinical outcomesPelvic irradiationRadiation therapyRevision rateSystematic reviewTotal hip arthroplasty

Identifiers

PMID41026223

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.