How to restore rotation center in total hip arthroplasty for developmental dysplasia of the hip by recognizing the pathomorphology of acetabulum and Harris fossa?

Zhang, Heng; Zhou, Jiansheng; Guan, Jianzhong; Ding, Hengfei; Wang, Zhiyan; Dong, Qirong

doi:10.1186/s13018-019-1373-9

Cited by 21 publications

(29 citation statements)

References 16 publications

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“…Compared with the top part, the pathological changes at the bottom of the acetabulum that was relatively minor in hip revision cases, and the remnant of Harris fossa and acetabular notches could always been found. Zhang H et al [6] reported that the acetabular center was located on the average of 28 mm (range 25~31 mm, depending on the size of the acetabulum) above the vertical bisection of the anterior and posterior acetabular notches line, and the acetabular center was also at the cephalic side of the Harris fossa, near semilunar cartilage. The acetabular center could be located accurately in the hip revision surgery by this method.…”

Section: Discussionmentioning

confidence: 99%

“…The remnant structures of the Harris fossa and acetabular notches on the bottom of the acetabulum were carefully exposed and identified. The acetabular center was located at a mean of 28 mm (range 25~31 mm, depending on the size of the acetabulum) above the perpendicular bisector of acetabular anterior and posterior notch line [5,6]. Sclerous acetabular bone bed was concentrically reamed using the above located point as the center of circles.…”

Section: Surgical Methodsmentioning

confidence: 99%

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Mid-term and long-term results of restoring rotation center in revision hip arthroplasty

et al. 2020

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Background: To restore rotation center exactly in revision hip arthroplasty is technically challenging, especially in Paprosky type III. The technical difficulty is attributable to the complicated acetabular bone defect. In this study, we discussed the method of restoring rotation center in revision hip arthroplasty and reported the clinical and radiological outcome of mid-term and long-term follow-up. Methods: This study retrospectively reviewed 45 patients (48 hips) who underwent revision hip arthroplasty, in which 35 cases (35 hips) were available for complete follow-up data. During the operation, the acetabular bone defect was reconstructed by impaction morselized bone graft, and the hip rotation center was restored by using remnant Harris fossa and acetabular notches as the marks. The clinical outcome was assessed using the Harris hip score. Pelvis plain x-ray was used to assess implant migration, stability of implants, and incorporation of the bone graft to host bone. Result: The average follow-up duration was 97.60 months (range 72-168 months). The average Harris hip score improved from 29.54 ± 10.87 preoperatively to 83.77 ± 5.78 at the last follow-up. The vertical distance of hip rotation center measured on pelvis x-ray was restored to normal, with the mean distance (15.24 ± 1.31) mm (range 12.4~17.3 mm). The mean loss of vertical distance of hip rotation center was (2.21 ± 0.72) mm (range 1.1~5.3 mm) at the last follow-up. Conclusion: Satisfactory clinical and radiological outcome can be obtained through restoring hip rotation center by using remnant Harris fossa and acetabular notches as the anatomical marks in revision hip arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Methodsmentioning

confidence: 99%

Mid-term and long-term results of restoring rotation center in revision hip arthroplasty

et al. 2020

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“…The Harris fossa was covered with osteophytes and restored its morphology by removing osteophytes (Fig.2B). The acetabular anterior and posterior notches were recognized and the perpendicular bisector of acetabular anterior and posterior notch line was marked.The acetabular center was loacted at 25 ~ 31 mm(mean 28.7 mm,depended on the size of the acetabulum) above the intersection point of the perpendicular bisector and acetabular anterior and posterior notch line (Fig.2C),which could also be located by ourself-developed acetabular center locator( Fig.2D) [7]. During the process of acetabular reaming, the anteversion was controlled in the range of 15°±10 °, while the inclination was 40°±10°, and the depth was to bottom of Harris fossa .…”

Section: Simulated Operation and Preoperative Planning For Restoring mentioning

confidence: 94%

“…The acetabular anterior and posterior notches were recognized and the perpendicular bisector of acetabular anterior and posterior notch line was marked. The acetabular center was loacted at 25 ~ 31 mm(mean 28.7 mm,depended on the size of the acetabulum) above the intersection point of the perpendicular bisector and acetabular anterior and posterior notch line [7] (Fig.4C).…”

Section: Surgical Techniquementioning

confidence: 99%

How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study

Zhang

Liu

et al. 2020

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Background: It is technically challenging to restore hip rotation center exactly in total hip arthroplasty (THA) for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip (DDH) due to the complicated acetabular morphology changes.In this study, we developed a new method to restore hip rotation center exactly and rapidly in THA with the assistance of three dimensional (3-D) printing technology.Methods: Seventeen patients (21 hips) with end-stage osteoarthritis secondary to DDH who underwent THA were included in this study. Simulated operations were performed on 3-D printed hip models for preoperative planning. The Harris fossa and acetabular notches were recognized and restored to locate acetabular center. The agreement in the size of acetabular cup and bone defect between simulated operations and actual operations were analyzed.Clinical and radiographic outcomes were recorded and evaluated.Results: The sizes of the acetabular cup of simulated operations on 3-D printing models showed a high rate of coincidence with the actual sizes in the operations(ICC value=0.930) There was no significant difference statistically between the sizes of bone defect in simulated operations and the actual sizes of bone defect in THA( t value=0.03，P value=0.97). The average Harris score of the patients was improved from (38.33±6.07) preoperatively to the last follow-up (88.61±3.44) postoperatively.The mean vertical and horizontal distances of hip rotation center on the pelvic radiographs were restored to (15.12 ± 1.25）mm and ( 32.49±2.83) mm respectively. No case presented dislocation or radiological signs of loosening until last follow-up.Conclusions: The application of 3-D printing technology faciliate orthopedists to recognize the morphology of Harris fossa and acetabular notches , locate the acetabular center and restore the hip rotation center rapidly and acurately.

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“…2C),which could also be located by ourself-developed acetabular center locator( Fig. 2D) [7]. During the process of acetabular reaming, the anteversion was controlled in the range of 15°±10 °, while the inclination was 40°±10°, and the depth was to bottom of Harris fossa.…”

Section: Simulated Operation and Preoperative Planning For Restoring mentioning

confidence: 96%

How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study

Zhang

Chen

et al. 2020

Preprint

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Abstract Background It is technically challenging to restore hip rotation center exactly in total hip arthroplasty (THA) for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip (DDH) due to the complicated acetabular morphology changes.In this study, we developed a new method to restore hip rotation center exactly and rapidly in THA with the assistance of three dimensional (3-D) printing technology. Methods Seventeen patients (21 hips) with end-stage osteoarthritis secondary to DDH who underwent THA were included in this study. Simulated operations were performed on 3-D printed hip models for preoperative planning. The Harris fossa and acetabular notches were recognized and restored to locate acetabular center. The agreement on the size of acetabular cup and bone defect between simulated operations and actual operations were analyzed.Clinical and radiographic outcomes were recorded and evaluated. Results The sizes of the acetabular cup of simulated operations on 3-D printing models showed a high rate of coincidence with the actual sizes in the operations(ICC value = 0.930) There was no significant difference statistically between the sizes of bone defect in simulated operations and the actual sizes of bone defect in THA( t value = 0.03,P value = 0.97). The average Harris score of the patients was improved from (38.33 ± 6.07) preoperatively to the last follow-up (88.61 ± 3.44) postoperatively.The mean vertical and horizontal distances of hip rotation center on the pelvic radiographs were restored to (15.12 ± 1.25)mm and ( 32.49 ± 2.83) mm respectively. No case presented dislocation or radiological signs of loosening until last follow-up. Conclusions The application of 3-D printing technology facilitates orthopedists to recognize the morphology of Harris fossa and acetabular notches, locate the acetabular center and restore the hip rotation center rapidly and accurately.

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How to restore rotation center in total hip arthroplasty for developmental dysplasia of the hip by recognizing the pathomorphology of acetabulum and Harris fossa?

Cited by 21 publications

References 16 publications

Mid-term and long-term results of restoring rotation center in revision hip arthroplasty

Mid-term and long-term results of restoring rotation center in revision hip arthroplasty

How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study

How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study

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