Experimental study of the installation acetabular component with uncoverage in arthroplasty patients with severe developmental hip dysplasia

Tikhilov, Rashid M.; Shubnyakov, I. I.; Burns, Scott; Shabrov, Nikolay; Kuzin, Alexey; Мазуренко, А. В.; Денисов, А. О.

doi:10.1007/s00264-015-2951-z

Cited by 11 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, we only evaluated the long-term durability of cemented THA in DDH with bulk bone graft, because this was not a randomised controlled study. An experimental study of acetabular exposure with DDH in the cementless acetabular component was previously conducted [27]. Although we preferred to graft the bone when the cup was covered up to 80 % by the iliac bone after full preparation of the acetabulum, as described by Gerber and Harris [15], there were no strict indications for bulk bone graft; thus, our study might have included some patients who did not require a bulk bone graft.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of acetabular reconstruction using three bulk bone graft techniques in cemented total hip arthroplasty for developmental dysplasia

Iida

Kawamura

et al. 2015

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose The aims of this retrospective study were to firstly introduce three practical bulk bone graft techniques based on acetabular morphology for dysplasia and secondly evaluate the long-term durability of acetabular reconstruction using those techniques combined with cemented total hip arthroplasty (THA). Methods The study comprised 101 consecutive THAs with a minimum follow-up of ten years; these procedures were categorised as being L shape (n=58), Wall (n=33) and D shape (n=10) types. Results At the last follow-up, all bone grafts acquired trabecular reorientation, and no evidence of revision for aseptic or radiological loosening was noted. Conclusions These bone graft techniques will be effective for improving the management of dysplasia in cemented THA by providing both acetabular reconstruction and cement containment.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term results of acetabular reconstruction using three bulk bone graft techniques in cemented total hip arthroplasty for developmental dysplasia

Iida

Kawamura

et al. 2015

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Additional cup support techniques can be performed if there is <65%–70% cup coverage. The resected femoral head is used for bone autografting.…”

Section: Direct Anterior Approach Total Hip Arthroplastymentioning

confidence: 99%

Total Hip Arthroplasty for Crowe Type IV Hip Dysplasia: Surgical Techniques and Postoperative Complications

Shi

Han

et al. 2019

Orthopaedic Surgery

View full text Add to dashboard Cite

Total hip arthroplasty (THA) of Crowe type IV developmental dysplasia of the hip (DDH) is challenging. Although traditional (lateral, posterolateral, and posterior) THA approaches have been used with great anatomic success, they damage periarticular muscles, which are already quite weak in type IV DDH. The recently developed direct anterior approach (DAA) can provide an inter‐nerve and inter‐muscle approach for THA of type IV dysplasia hips. However, femur exposure with the DAA could be difficult during surgery and it is hard to apply femoral shortening osteotomy. THA techniques used for type IV DDH include anatomic hip center techniques (true acetabular reconstruction) and high hip center techniques, wherein an acetabulum is reconstructed above the original one. Although anatomic construction of the hip center is considered “the gold standard” treatment, it is impossible if the anatomical acetabular is too small and shallow. Procedures used to support type IV DDH reduction with anatomic hip center techniques include greater trochanter osteotomy, lesser trochanter osteotomy, and subtrochanteric osteotomy. However, these techniques have yet to be standardized, and it is unclear which is best for type IV DDH. One‐state and two‐state non‐osteotomy reduction techniques have also been introduced to treat type IV DDH. Potential complications of THA performed in patients with type IV DDH include leg length discrepancy (LLD), peri‐operative femur fracture, nonunion of the osteotomy site, and nerve injury. It is worth noting that nowadays an increasing number of Crowe type IV DDH patients are more sensitive to postoperative LLD.

show abstract

“…analyzed the predictive value of preoperative digital templating and determined that when cup coverage was <65%, 65%–75%, or >75%, then the percentages of hips that required structural support were 100%, 20%, and 10%, respectively. In a mechanical experiment, Tikhilov et al . noted that the post‐surgical body weight of a patient with DDH is a crucial factor influencing cup stability.…”

Section: Confirmation Of Acetabular Positionmentioning

confidence: 99%

Preoperative Planning for Total Hip Arthroplasty for Neglected Developmental Dysplasia of the Hip

Shi

Cheng

et al. 2019

Orthopaedic Surgery

View full text Add to dashboard Cite

Developmental dysplasia of the hip (DDH) is accompanied by morphological alterations on both the acetabular and the femoral side. Total hip arthroplasty (THA) provides effective treatment in cases of neglected DDH but requires elaborate preoperative planning. To determine the morphological changes resulting from the dysplasia, the anatomic acetabular position, the height of the femur head dislocation, the height of the femur head dislocation, and the combined anteversion must all be established. In addition, a vital and complicated process of strategizing leg length balance must be conducted in cases of severe DDH. Each type of leg length discrepancy (LLD), including bony and functional and anatomical LLD, should be evaluated in the context of the presence or absence of a fixed pelvic tilt. Moreover, with severe unilateral dislocated hips, a more inferior change in the original rotational center of the hip must be accounted for. Due to these multiple morphological changes, the accurate size of the prosthesis and the cup position are difficult to predict. In comparison with other methods, CT scan‐based 3‐dimensional templating provides the best accuracy. Despite the presence of anatomic alterations, various types of acetabular and femoral prostheses have been developed to treat hip dysplasia. Both cemented and cementless cups are used in DDH cases. In DDH accompanied by insufficient acetabular bone stock, a cemented cup combined with bone graft provides a reliable treatment. Monoblock stems can be used when the combined anteversion is less than 55°, and a modular stem system when this parameter is greater than 55°. Customized stems can be designed for DDH coupled with severe proximal femoral distortion. A ceramic‐on‐ceramic bearing is considered optimal for young DDH patients.

show abstract

Experimental study of the installation acetabular component with uncoverage in arthroplasty patients with severe developmental hip dysplasia

Abstract: This study provides additional guidance on optimal acetabular uncoverage assessment and fixation methods of surgeons performing THA on patients with DDH.

Cited by 11 publications

References 19 publications

Long-term results of acetabular reconstruction using three bulk bone graft techniques in cemented total hip arthroplasty for developmental dysplasia

Long-term results of acetabular reconstruction using three bulk bone graft techniques in cemented total hip arthroplasty for developmental dysplasia

Total Hip Arthroplasty for Crowe Type IV Hip Dysplasia: Surgical Techniques and Postoperative Complications

Preoperative Planning for Total Hip Arthroplasty for Neglected Developmental Dysplasia of the Hip

Contact Info

Product

Resources

About