Long-term outcomes of the hip shelf arthroplasty in adolescents and adults with residual hip dysplasia: a systematic review

Abstract

Background and purpose — The shelf arthroplasty was the regular treatment for residual hip dysplasia before it was substituted by the peri-acetabular osteotomy. Yet, evidence regarding the survival of shelf arthroplasty surgery has never been systematically documented. Hence, we investigated the survival time of the shelf procedure until revision to THA in patients with primary hip dysplasia. Factors that influenced survival and complications were also examined, along with the accuracy of correcting radiographic parameters to characterize dysplasia. Material and methods — The inclusion criteria were studies of human adolescents and adults (> 16 years) with primary or congenital hip dysplasia who were treated with a shelf arthroplasty procedure. Data were extracted concerning patient characteristics, survival time, complications, operative techniques, and accuracy of correcting radiographic parameters. Results — Our inclusion criteria were applicable to 9 studies. The average postoperative Center-Edge Angle and Acetabular Head Index were mostly within target range, but large variations were common. Kaplan–Meier curves (endpoint: conversion to THA) varied between 37% at 20 years’ follow-up and 72% at 35 years’ follow-up. Clinical failures were commonly associated with pain and radiographic osteoarthritis. Only minor complications were reported with incidences between 17% and 32%. Interpretation — The shelf arthroplasty is capable of restoring normal radiographic hip parameters and is not associated with major complications. When carefully selected on minimal osteoarthritic changes, hip dysplasia patients with a closed triradiate cartilage may benefit from the shelf procedure with satisfactory survival rates. The importance of the shelf arthroplasty in relation to peri-acetabular osteotomies needs to be further (re)explored.

Comparing Hip Dysplasia in Dogs and Humans: A Review

“…Shelf arthroplasty is a commonly used salvage procedure for HD in humans ( 86 ). It involves the placement of an autologous bone graft outside of the joint capsule superior to the acetabulum ( 87 , 88 ).…”

“…This procedure is preferably performed in younger patients with minimal arthritic changes, however it is mostly reserved as a salvage procedure as other treatments are not eligible. The survival of the shelf procedure can be up to 72% at 35 years of follow-up ( 86 ). A similar procedure called the biocompatible osteoconductive polymer (BOP) procedure has been described as an alternative to TPO in adolescent dogs ( 12 , 75 , 76 ).…”

The feasibility of ultrasound Graf method in screening infants and young children with congenital hip dysplasia and follow-up of treatment effect

“…The possible reason of the increase may be related to the maturity of sonographers' operating technology, development of equipment, and spread of diseases in recent years. In addition to ultrasound, clinical physical examination, X-ray film, and magnetic resonance imaging (MRI) are the other main methods for clinical diagnosis of hip joint diseases in infants and young children (8). Although low-dose CT reduces the radiation dose, the image quality of infants is easy to be poor due to the age problem, and the radiation dose still exists.…”

Patient-specific 3D-printed shelf implant for the treatment of hip dysplasia tested in an experimental animal pilot in canines

“…PAO is an invasive surgery with an extensive learning curve and is associated with a high rate of complications 8 . Therefore, the concept of shelf arthroplasty 9 could be revisited by using titanium additive manufacturing technologies 10 to develop 3D-printed joint preserving implant in a personalized approach 11 , 12 .…”