Systematic Evaluation Of The Curative Effect Of Femoral Osteotomy For Perthes Disease

Objective:To systematically evaluate the curative effect of Femoral Osteotomy on Perthes'disease.Methods:A literature about the Femoral Osteotomy in treatment of Perthes'disease was searched through China National Knowledge Infrastructure?CNKI?,Wanfang Database,Chinese Biomedical Literature Database?CBM?,Pubmed,Embase,Cochrane library and Web of science that created from inception to December 2017.According to the NOS criteria evaluated the quality of studies and extracted data.Meta-analysis was performed by ReviewM5.3.Results:There are 3 kinds of results through analysis from 22 literatures what were included by us,as the following said.1.To comparison between femoral osteotomy and conservative treatment by Mose method that 10 literatures were included.Femoral osteotomy with 462 hips,conservative treatment with 484 hips,In Herring B or Catterall III,there is a significant difference in good result between FO group and the control group?OR=2.39,95%CI?1.34,4.25?,P=0.003?,there is a significant difference in poor result between FO group and the control group?OR=0.30,95%CI?0.23,0.40?,P<0.01 OR_?=2.93,95%CI?1.20,4.74?,P=0.01?,there is no significant difference in fair result between FO group and the control group?OR=0.98,95%CI?0.72,1.33?,P=0.88?.Through the subgroup Analysis,We can see there is a significant difference in good and poor result between FO group and the control group when Patients who older than 6 years(OR _good=2.93,95%CI?1.2,4.74?,P=0.01;OR poor=0.16,95%CI?0.08,0.32?,P<0.01).2.Femoral osteotomy and non inclusive surgical by Mose method that 3 literatures were included.Femoral osteotomy with 29 hips,noninclusive surgical with 12 hips,there is a significant difference in good result between FO group and the control group?OR=2.54,95%CI?1.02,6.29?,P=0.04?;there is no significant difference in fair and poor result be-tween FO group and the control group(OR_fair=0.85,95%CI?0.35,2.06?,P=0.73,OR _poor=0.34,95%CI?0.11,1.01?P=0.05).3.Femoral osteotomy and Pelvic osteotomy by Mose method that 6 literatures were included.femoral osteotomy with 180 hips,Pelvic osteotomy with 152 hips,Age 5.8 to8.9,Herring B/Catterall III,there is no significant difference in good?fair and poor result between FO group and the control group(OR _good=0.93,95%CI?0.53,1.64?,P=0.81;OR _fair=1.06,95%CI?0.53,1.80?,P=0.83;OR _poor=1.05,95%CI?0.59,1.88?,P=0.86).Conclusion:The curative effect of femoral osteotomy was better than that of conservative treatment when children who suffered LCPD older than 6 years or above Herring B or Catterall III.The curative effect of femoral osteotomy was better than that of non inclusive surgical treatment.The curative effect has no different between femoral osteotomy and pelvic osteotomy when children who suffered LCPD between 5.8 and 8.9years old or in Herring B or Catterall III.