Hip replacement for congenital dislocation and dysplasia

Lund, Kurt H. D.; Termansen, Niels B.

doi:10.3109/17453678508993036

Cited by 31 publications

(11 citation statements)

References 10 publications

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“…As an alternative to bone grafting some authors have described the use of small acetabular components in an anatomical or superior position. 25,[35][36][37][38][39][40][41] Others have advocated proximal or medial placement of the acetabular component, sometimes even fracturing the medial wall. 38,[42][43][44][45] However, these methods compromise the biomechanics of the hip.…”

Section: Discussionmentioning

confidence: 98%

Total hip replacement with a superolateral bone graft for osteoarthritis secondary to dysplasia

Jong

Haverkamp

Vis³

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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We evaluated the long-term results of 116 total hip replacements with a superolateral shelfplasty in 102 patients with osteoarthritis secondary to developmental dysplasia of the hip. After a mean follow-up of 19.5 years (11.5 to 26.0), 14 acetabular components (12%) had been revised. The cumulative survival at 20 years was 78%, with revision for loosening of the acetabular component as the end-point. All grafts were well integrated and showed remodelling. In six grafts some resorption had occurred under the heads of the screws where the graft was not supporting the socket. Apart from these 14 revisions, seven acetabular components had possible radiological signs of loosening at a mean follow-up of 14.5 years, one had signs of probable loosening, and five had signs of definite loosening. These results indicate that this technique of bone grafting for acetabular reconstruction in hip dysplasia is a durable solution for cemented acetabular components.

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Section: Discussionmentioning

confidence: 98%

Total hip replacement with a superolateral bone graft for osteoarthritis secondary to dysplasia

Jong

Haverkamp

Vis³

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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“…Restoration of the normal centre of rotation creates a proximal bony defect which can be dealt with by cement or a bone graft [1,8,21,22]. A graft is appropriate when the lateral uncovering of the acetabular cup exceeds 30% of its circumference, and when the anterior and posterior borders of the cup are not supported by the host bone.…”

Section: Discussionmentioning

confidence: 99%

Total hip replacement with bone grafting using the removed femoral head in severe acetabular dysplasia

Stringa¹,

Pitto²,

Muria³

et al. 1995

International Orthopaedics

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We carried out total hip replacement and femoral head bone-grafting in 21 hips with congenital dysplasia or dislocation, obtaining as much support of the cup by the host bone as was possible. A Charnley small or extra small cup was implanted in 20 cases and a miniature femoral component in 15. The results of 20 hips were reviewed prospectively at an average of 10 years. Nineteen patients had no pain. Three cups showed radiological signs of loosening, one was causing other symptoms. All the stems, except one, were radiologically stable and were symptomless. The graft had fused without resorption in 18 cases. Two grafts showed severe resorption with loosening of the cup. Satisfactory long term results of total hip replacement and femoral head bone-grafting can be achieved using special surgical techniques and the appropriate components. Medialisation of the hip and the use of small cups are important in allowing sufficient support of the prosthesis by bone so that the distribution of load on the graft is minimised. The grafted femoral head provides suitable bone stock for reconstruction of the acetabulum.

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“…Due to these pronounced anatomical changes, hip arthroplasty in patients with dysplastic osteoarthritis (OA) is considered a complicated surgical operation (OP) (Crowe et al, 1979;Henrich et al, 2007;Park et al, 2007;Shen et al, 2009;Kärrholm et al, 2015;Helkemaa et al, 2016) with a considerably higher risk of complications compared to patients with degenerative OA. Many authors believe that during THA, it is advisable to position the AC-EP in the primary joint socket (Charnley, 1979;Lund and Tennansen, 1985;Symeonides et al, 1997;Bi-canic et al, 2009), thus positioning the hip rotation center at the level of the anatomical joint socket center. According to these authors, the EP's anatomical positioning ensures the proper functioning of the gluteal muscles, allowing walking without pronounced limping.…”

Section: Introductionmentioning

confidence: 99%

Choice of the Acetabular Component Placement in Dysplastic Hip Patients

Zebolds

Pētersons

Jumtiņš

2019

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Total hip arthroplasty (THA) in patients with hip dysplasia is a challenging surgical operation. Many orthopedic surgeons concur that the anatomical placement of the acetabular components of endoprostheses (AC-EPs) during THA yields the best result. However, there are advocates of the high rotation center of the hip joint after replacement surgery. In our study, we compared the outcomes of THA based on the placement of acetabular cups to identify the most favorable site for AC-EPs in patients with varying grades of dysplastic osteoarthritis. Our study included 88 patients with dysplastic hip osteoarthritis who underwent 106 THAs during a three-year period using cementless fixation endoprostheses. Functional results were assessed by Merle d’Aubigne and Postel’s method and by instrumental gait analysis (IGA). Gait deviation index was calculated based on IGA to compare results in different acetabular component placement groups. Functional assessment of patients by Merle d’Aubigne and Postel’s grading method and IGA showed no significant difference in results due to the placement of the acetabular component. Most complications were found in the severe dysplasia patients group with the anatomical placement of the AC-EP. The appropriate location of cementless acetabular cups during THA in dysplastic hips depends on the grade of dysplasia, expected elongation of the leg, and the potential for adequate bone coverage for the AC-EP. In cases of severe dysplasia, the placement of the AC-EP in the secondary socket can provide a good functional outcome and reduce the risk of complications.

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Hip replacement for congenital dislocation and dysplasia

Cited by 31 publications

References 10 publications

Total hip replacement with a superolateral bone graft for osteoarthritis secondary to dysplasia

Total hip replacement with a superolateral bone graft for osteoarthritis secondary to dysplasia

Total hip replacement with bone grafting using the removed femoral head in severe acetabular dysplasia

Choice of the Acetabular Component Placement in Dysplastic Hip Patients

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