Background Acetabular orientation changes after periacetabular osteotomy (PAO) lead to technical change when performing subsequent total hip arthroplasty (THA). There is no unified consensus regarding the solution for acetabular component installation after PAO. In the current study, we performed computed tomography (CT)-based simulation of acetabular component installation and compared the acetabular defect and component position following THA after PAO and the same patient before PAO. Methods From January 2014 to December 2018, pelvic models of 28 patients (28 hips) underwent PAO and with the risk factors to develop secondary osteoarthritis. The acetabular reconstruction process was simulated using 3D models from CT data, and the acetabular component coverage was calculated in 3D space based on the measurement and algorithm we proposed. We evaluated the anterior, posterior, superior, inferior acetabular sector angle (ASA), the medial wall thickness (MWT), and the distance from the hip center to the plane of pubic symphysis and ossa sedentarium in the study group (post-PAO group) and control group (pre-PAO group). In addition, we investigated the changes in the acetabular component covering and size between the two groups. Results A-ASA and I-ASA values were significantly smaller in the post-PAO group than in the pre-PAO group. The S-ASA and distance values were significantly bigger in the post-PAO group. Compared to the pre-PAO group, the post-PAO group has a bone defect in the anterior and inferior medial. However, the post-PAO group has to elevate the cup to improved component coverings. Conclusion Acetabular defection following simulation of cup installation after PAO was significantly changed compared to those without PAO. Elevation of hip joint centers as much as 4 mm and increase acetabular cup anteversion were therapeutic options for DDH patients following THA after PAO
Background China has neither a nationwide joint replacement registry similar to Sweden and New Zealand nor a universal healthcare (medical insurance) registry similar to Hong Kong and Singapore to check. The purpose was to initially understand the distribution characteristics of gender, age and etiology of patients undergoing total hip replacement for non-traumatic reasons nationwide. Methods The clinical data of patients who underwent initial artificial total hip replacement due to non-traumatic reasons in joint surgery of 13 large general first-class hospitals at Grade 3 in northern, western, eastern, southern, and southwestern China were collected. After the classification of patients by gender, the etiological characteristics and age distribution of male and female patients were compared, as well as male to female ratio and disease composition ratio of patients of different ages, distribution of causes in different regions, composition ratio, and age distribution characteristics of patients of different ethnic groups. Results In this study, the data of a total of 7663 patients in joint surgery of 13 general first-class hospitals at Grade 3 from 2015 to 2017 were collected, and 7622 patients were finally included in the study after excluding missing age, gender and some foreign patients. The main causes of diagnosis in male patients were AVN, DDH, and OA, and top 3 causes in female patients were DDH, AVN, and OA. Conclusions This study initially understand the distribution characteristics of gender, age and etiology of patients undergoing total hip replacement for non-traumatic reasons nationwide, and further guide the clinical diagnosis, early prevention and treatment of the disease and provide data.
Periacetabular osteotomy (PAO) is an effective technique to treat symptomatic hip dysplasia. However, following PAO, some patients still experience persistent pain or development of hip arthritis, requiring total hip arthroplasty (THA). Issues such as whether patients with PAO are necessarily at increased risk of post-THA complications and revision of the prosthesis remain debatable. The purpose of this study was to evaluate the biomechanical influence of PAO on the acetabulum after THA by finite element analysis. Eight patients with developmental dysplasia of the hip (DDH) diagnosed in the Fourth Medical Center of the PLA General Hospital were enrolled in this research. Patientspecific hip joint models were reconstructed from computed tomography scans,
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