New Method Addressing the Problem of Using Ceramic-on-Ceramic Bearing in Too Small Acetabulum of High-Riding DDH Patients with THA

Zhou, Yonggang; Sun, Changjiao; Wang, Yan

doi:10.1053/j.sart.2012.12.006

Cited by 18 publications

(24 citation statements)

References 43 publications

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“…However, the center of the femoral head in the operative side may be affected by the position of the acetabular shell. For the patients with Crowe type IV DDH in our institute, the acetabular shell was located in the posterior and inferior position of the true acetabulum [12]. The height of the center of the acetabular shell in operative side was lower than that in the contralateral side, which may cause the difference of CH-TP to be inconsistent with the patients' perception on LLD.…”

Section: Discussionmentioning

confidence: 91%

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Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

Shen

Sun

et al. 2020

Preprint

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Background: The study assessed the correlation among the patients’ perception on leg length discrepancy (LLD) after total hip arthroplasty (THA) in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH) and the four methods of measuring the leg length in the full-length standing anteroposterior radiographs. Methods: 60 patients with unilateral Crowe type IV DDH were recruited in this retrospective study between January 2012 and January 2019. Four methods of measurement were used: (1) TD-TP: distance between the inferior aspect of teardrop and the midpoint of tibial plafond (TP). (2) CH-TP: distance between the center of femoral head or acetabular cup and the TP. (3) GT-TP: distance between the apex of greater trochanter and the TP. (4) FL + TL: the sum of femoral length and tibial length. Results: Association was found among the patients’ perception on LLD with difference in TD-TP (OR, 1.157), and the difference in FL + TL (OR, 1.166). The area under the curve of the difference in FL + TL and the difference TD-TP (0.704 and 0.679) was significantly higher than those of the difference in CH-TP and the difference in GT-TP (0.564 and 0.483). With the calculated threshold of LLD set at 9.0 mm, the sensitivity and specificity of the difference in TD-TP and the difference in FL + TL were 57.7%, 79.4% and 61.5%, 79.4%, respectively.Conclusion: Patients’ perception on LLD had good correlation and reliability on the difference of FL + TL and the difference of TD-TP.

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Section: Discussionmentioning

confidence: 91%

“…All THA were performed by a single surgeon in the lateral decubitus position, with posterolateral approach. The procedure has been described in detail in our previous studies [3,11,12]. A cementless acetabular shell that was xed by two screws was placed at the level of the true acetabulum.…”

Section: Surgerymentioning

confidence: 99%

Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

Shen

Sun

et al. 2020

Preprint

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“…Joint capsulectomy, gluteal sling release, and iliopsoastenotomy was performed. In order to use ceramic on ceramic bearing, the cup (range 44-46 mm) was implanted at the anatomic position by reaming the acetabulum posteriorly and inferiorly [29]. Two or three screws were used to augment primary stability of the cup.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Absence of False Acetabulum is a Potent Indicator for Predicting the Use of Subtrochanteric Osteotomy in Total Hip Arthroplasty for High Dislocated Hips

Sun¹,

Zhang²,

Du³

et al. 2020

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Introduction: This study aimed to evaluate the predictive values of false acetabulum for assessment of whether to use subtrochanteric osteotomy.Materials and Methods: We retrospectively included a total of 182 patients (232 hips) affected by Crowe type IV developmental dysplasia who underwent primary THA with modular cementless stem from April 2008 to May 2019 in our institution. Based on radiographs and operative notes, we found 175 hips were performed with subtrochanteric osteotomy and 57 without subtrochanteric osteotomy, which was named (subtrochanteric osteotomy) STO group and non-STO group, respectively. The predictive values of absence of false acetabulum and distalization of greater trochanter were analyzed using receiver operating characteristic (ROC) curves.Results: ROC curves showed that absence of false acetabulum and distalization of greater trochanter had the AUCs of 0.957 and 0.987, respectively. And there was no statistical significance in the difference of these two AUCs (P=0.392). The optimal threshold for the distalization of greater trochanter was 4.83 cm, which resulted in a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 92.6%, 100%, 100%, and 81.4%, respectively. For the absence of false acetabulum, the sensitivity, specificity, PPV, and NPV were 94.9%, 96.5%, 98.8%, and 85.9%, respectively.Conclusions: The absence of false acetabulum may be a potent indicator in predicting the use of subtrochanteric osteotomy in high dislocated hips.

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“…It should be noted that the small diameter of the bony acetabulum in high dislocated hips typically dictates the use of smaller acetabular component. In spite of the narrow space for cup placement, many authors found that the bone stock at posterior part of the true acetabulum was abundant [7][8][9][10]. Besides, due to the great variations of femoral version, mismatch between the proximal and distal parts of the femur can be encountered in the dislocated hips, which may limit the use of conventional double-wedged stems.…”

Section: Surgical Considerationsmentioning

confidence: 99%

Current concepts in developmental dysplasia of the hip and Total hip arthroplasty

Wang

2019

Arthroplasty

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Developmental dysplasia of the hip (DDH) is a spectrum of pathology that involves dysplasia of both the acetabulum and the femur. If left untreated, it can develop to hip pain and osteoarthritis, which eventually require total hip arthroplasty (THA). A broad array of anatomical abnormalities of the acetabulum and femur, plus the younger age of DDH patients make THA a great challenge. Meticulous operation planning with various options is one of the most important prerequisites of a successful THA. This review presents the current concepts of acetabular and femoral reconstruction in THA for DDH, including high hip center, acetabular bone deficiency, highly porous metal, correction of femoral anteversion, femoral shortening osteotomy, stem selection, among others.

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New Method Addressing the Problem of Using Ceramic-on-Ceramic Bearing in Too Small Acetabulum of High-Riding DDH Patients with THA

Cited by 18 publications

References 43 publications

Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

Absence of False Acetabulum is a Potent Indicator for Predicting the Use of Subtrochanteric Osteotomy in Total Hip Arthroplasty for High Dislocated Hips

Current concepts in developmental dysplasia of the hip and Total hip arthroplasty

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