Integrated acetabular prosthesis versus bone grafting in total hip arthroplasty for Crowe type II and III hip dysplasia: a retrospective case–control study

Abstract

Background Many methods of acetabular reconstruction with total hip arthroplasty (THA) for Crowe type II and III adult developmental dysplasia of the hip (DDH) acetabular bone defect have been implemented clinically. However, there was no study comparing the results of integrated acetabular prosthesis (IAP) with bone grafting (BG). Method The clinical data of 45 patients with unilateral Crowe type II and III DDH who underwent THA were retrospectively analyzed. The patients were divided into two groups: 25 patients using 3D printed IAP (group A) and 20 patients using BG (group B). Clinical and radiographic outcomes were evaluated. Results There were no significant differences between the two groups in Harris hip score (HHS) (preoperative, 6 months postoperative and the last follow-up), leg length discrepancy (LLD), cup inclination, cup anteversion, vertical center of rotation (V-COR) and horizontal center of rotation (H-COR) and proportion of cup coverage (P > 0.05). The HHS in group A was higher than in group B at 1 and 3 months postoperative (P<0.05). The surgical time and time to full weight-bearing in group A was shorter than in group B (P<0.05). The blood loss in group A was less than in group B (P<0.05). No complications were observed in either group during the follow-up period. Conclusion IAP and BG have similar radiographic outcomes and long-term clinical efficacy in THA for Crowe type II and III DDH, but IAP technique has higher surgical safety and facilitates the recovery of hip joint function, which is worthy of clinical promotion.