Outcome of Hip Resurfacing Arthroplasty in Patients with Developmental Hip Dysplasia

Naal, Florian D.; Schmied, Matthias; Munzinger, U.; Leunig, Michael; Hersche, Otmar

doi:10.1007/s11999-008-0456-4

Cited by 25 publications

(14 citation statements)

References 20 publications

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“…Additionally, 68% of the patients had a HOOS score greater than 80 points for all five categories and 85% of patients had postoperative regular involvement in moderate physical activities for the return to previous physical activities, a new demand in this type of population [18,38,43]. No patient reported thigh pain when asked, whereas numerous studies of conventional cementless stems showed some rates of thigh pain as much as 27% [8,25,35,44].…”

Section: Discussionmentioning

confidence: 99%

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Flécher

Pearce

Parratte

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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THA in young patients is challenging regarding restoration and survival because patients are young, active, and tend to have disturbed anatomy. We asked whether a three-dimensional custom cementless stem could restore hip function, decrease osteolysis and wear, and enhance stem survival in young patients. We retrospectively reviewed 212 patients (233 hips) younger than 50 years (mean, 40 years) at a followup of 5 to 16 years (mean, 10 years). The Merle D'Aubigné-Postel and Harris hip scores improved at last followup. No thigh pain was recorded for any of the patients; 187 of the 212 patients (88%) had full activity recovery, 206 had full range of motion, and 151 had a score greater than 80 points for all five categories of the Hip disability and Osteoarthritis Outcome score. Five patients had femoral osteolysis not associated with pain. With revision for any reason as an end point, the survivorship was 87% (range, 77%-97%) at 15 years, and considering stem revision only, the survivorship was 93% (confidence interval, 90%-97%) at 15 years. Our data compare favorably with those from series using standard cementless stems at the same followup with a high percentage of patients achieving functional restoration and a low rate of complications.

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Section: Discussionmentioning

confidence: 99%

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Flécher

Pearce

Parratte

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Others have reported that the outcomes for HRA are worse for dysplasia than for OA patients [24,25]. In Amstutz's early study of dysplasia [18], there were more problems on the femoral side with a femoral neck fracture rate of 8.5%.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of dysplasia as the source of worse outcome in young female patients after hip resurfacing arthroplasty

Gross

Liu

2011

International Orthopaedics (SICOT)

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Purpose Smaller femoral component size has been implicated as underlying the risk factor that explains the higher failure rate in women who have a hip resurfacing arthroplasty (HRA). We suspect that the diagnosis of dysplasia may be a more important causative risk factor than either small component size or female gender. Methods From January 2002 to July 2008, a total of 1,216 HRA cases, 1,082 with the primary diagnosis of osteoarthritis and 134 with dysplasia, were included in this study. Of them, 867 cases were performed in men and 349 performed in women. The average femoral component size was 51±4 mm. Cox proportional hazard regression models were used to evaluate the significance of each variable and determine the causative risk factors for failure. Results The average follow-up was 5±2 years. Thirty-nine cases failed (20 in men vs. 19 in women). The failure rate for the whole group was 3.2% (2.3% in men vs. 5.4% in women; P=0.01). Dysplasia (P=0.05) was identified as the only significant risk factor in our multi-variable analysis; small femoral component size (P=0.09) and gender (P= 0.76) were not significant risk factors. Women with the primary diagnosis of dysplasia had a survivorship rate of only 75% compared to 93% for the entire group at eightyear follow-up post-operatively. Conclusions In our study, we found that the high incidence of dysplasia in young women undergoing HRA was the reason that women had a higher failure rate after HRA. In dysplasia, 70% of failures were due to acetabular problems, of which 50% were due to failure of fixation and 20% due to adverse wear.

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“…Conservation of bone stock, not only on the femoral side, is an increasingly important issue in THA, considering the demographics of patients are changing toward an increasing proportion of younger and more active individuals [17][18][19]. These patients in their 40s and 50s are likely to undergo revision THA later during life, which would be aggravated by compromised bone stock owing to excessive bone removal during primary THA [3,19].…”

Section: Discussionmentioning

confidence: 99%

“…The life expectancy of these patients, mainly in their 40s and 50s, may exceed 30 years. Many patients seek hip arthroplasty relatively early and do not accept activity restrictions after surgery [17,18]. Therefore many of these patients likely will require additional hip surgery or revision arthroplasty later in their lives.…”

Section: Introductionmentioning

confidence: 99%

Does Hip Resurfacing Require Larger Acetabular Cups Than Conventional THA?

Naal

Kain²,

Hersche

et al. 2009

Clin Orthop Relat Res

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Outcome of Hip Resurfacing Arthroplasty in Patients with Developmental Hip Dysplasia

Cited by 25 publications

References 20 publications

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Prevalence of dysplasia as the source of worse outcome in young female patients after hip resurfacing arthroplasty

Does Hip Resurfacing Require Larger Acetabular Cups Than Conventional THA?

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