Severity of hip dysplasia and loosening of the socket in cemented total hip replacement

Chougle, A.; Hemmady, Mukesh; Hodgkinson, J.P.

doi:10.1302/0301-620x.87b1.15199

Cited by 72 publications

(49 citation statements)

References 24 publications

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“…In this study, there was a high rate of postdysplastic hips (38 %) and a signifi cantly larger number of these were among the revised cases (p = 0.001). This signifi cantly compromised the survival of the prosthesis in spite of the fact that the vast majority of these cases were those of the Hartofi lakidis type I which should result in survivorship comparable to primary osteoarthritis 22 . Moreover, Castoldi et al used ABG I in 49 postdysplastic hips (31.2 %) and they did not report inferior results for that group of patients 17 .…”

Section: Discussionmentioning

confidence: 99%

Poor Survival of Abg I Hip Prosthesis in Younger Patients

Gallo¹,

Langová²,

Havranek³

et al. 2008

BIOMED PAP

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Background: Hydroxyapatite coated (HAC) hip implants have been used in clinical practice for more than two decades. However, the majority of studies have reported only intermediate term outcomes that are not reliable for predicting long-term behavior in all implants. The aim of this study was to determine the performance of HAC total hip arthroplasty in younger patients over a 10-year follow-up period. Methods and Results:This was an observational retrospective study of a 137 consecutive hips with the ABG I prosthesis. Of these, 128 were available for the last investigation. Median duration of follow-up was 10.9 years. The mean age at time of index surgery was 46±6.7 years. Probability of implant survival was estimated using the Kaplan-Meier method. The overall 12-year cumulative survival was 0.55 (95% CI, 0.443-0.659). Periprosthetic osteolysis (57 %) was the most frequent reason for failure followed by aseptic loosening (28 %). When only aseptic loosening was included in the analysis, the same fi gures for cup and stem were 0.873 (95% CI, 0.808-0.938) and 0.992 (95% CI, 0.976-1.0), respectively. Patients with a smaller cup size were those at high risk for revision due to wear-related complications (odds ratio, OR=4.3; 95% CI, 1.734-10.555).Conclusion: This study reports one of the poorest 12-year survivorship data for cementless acetabular component in the literature. The main reason for premature failure was osteolysis, strongly related to high wear rate of polyethylene.

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Section: Discussionmentioning

confidence: 99%

Poor Survival of Abg I Hip Prosthesis in Younger Patients

Gallo¹,

Langová²,

Havranek³

et al. 2008

BIOMED PAP

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“…Several classification systems have been used to describe the different types of CHD in adults [1][2][3][4]. However, the reliability of those systems has not explicitly been the focus of attention and their validity has not been, to our knowledge, been reported.…”

Section: Discussionmentioning

confidence: 99%

“…For the classification of congenital hip disease (CHD) in adults various systems have been proposed [1,12,16,17]. The Hartofilakidis et al classification system, initially published in 1988, relies on intraoperative findings to describe the hip pathology encountered during the operation [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Reliability and validity of the Hartofilakidis classification system of congenital hip disease in adults

Yiannakopoulos

Xenakis

Karachalios

et al. 2007

International Orthopaedics (SICOT)

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The reliability and validity of the Hartofilakidis et al. classification system in adults with congenital hip disease (CHD) were examined. The radiographs of 102 adult patients (158 hips) with CHD were independently assessed by three senior surgeons. Interobserver variability was assessed by examining the agreement between the three raters while validity of the classification system was assessed by examining the agreement between the assessment by either one of the three raters and the intraoperative finding (reference standard). The interobserver agreement between the three observers was high ranging from 0.720 to 0.854 (substantial to excellent) while the agreement of the preoperative prediction with the intraoperative findings was 87.4% (K=0.823, excellent agreement). The Hartofilakidis et al. classification system reliably predicts from preoperative pelvis radiographs the bone deficiencies encountered during the operation.Résumé Nous avons voulu tester dans ce travail la fiabilité et la viabilité de la classification d'Hartofilakidis dans les séquelles des affections congénitales de la hanche. Les radios de 102 adultes (158 hanches) avec lésions congénitales ont été analysées, de façon indépendante par trois chirurgiens seniors avec validation inter observateur et intra observateur. Les résultats de cette analyse inter observateur sont hautement significatifs de 0.720 à 0.854 et les prévisions pré opératoires confirmées par les constatations per opératoires sont excellentes 87.4% (k=0.823). La classification d'Hartofilakidis est un système parfaitement viable qui permet de prévoir un pré opératoire les lésions que l'on pourra constater en per opératoire.

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“…A number of studies showed [7][8][9][10][11][12][13] that THR in the setting of developmental dysplasia has higher rates of complications and inferior outcomes when compared with THR performed for primary osteoarthritis. Moreover, the results depend on the severity of dysplasia, and patients with lower grades of dysplasia tend to have better results than patients with higher grades of dysplasia [14], so interpretation of long-term results after THR requires detailed information about the degree of dysplasia.…”

Section: Introductionmentioning

confidence: 99%

The Eftekhar and Kerboul classifications in assessment of developmental dysplasia of the hip in adult patients. Measurement of inter- and intraobserver reliability

et al. 2008

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Aim: To measure the inter-and intraobserver reliability of two radiologic classification systems in the evaluation of severity of osteoarthritis secondary to developmental dysplasia of the hip in adult patients and to compare these systems to historically published data on two more commonly used classification systems described by Crowe and by Hartofikakidis. Material and methods: Eighty-six dysplastic hips on 66 anteroposterior standard pelvic x-rays were rated according to the criteria of Eftekhar and Kerboul by three observers with different levels of clinical training. To assess intraobserver reliability, the measurement was repeated 3 months later. Statistical analysis was performed by calculating the weighted kappa correlation coefficient and the overall kappa coefficient. Results: Both classification systems showed a sufficient interobsever reliability, reaching a kappa coefficient of 0.73 for the system according to Eftekhar and 0.716 for the Kerboul classification system. Intraobserver reliability revealed a kappa coefficient of 0.778 for the Eftekhar system and 0.697 for the classification according to Kerboul. Conclusion: Both systems showed good inter-and intraobserver reliability for use in daily practice. However, they did not reach the known reliability of the grading systems published by Crowe and by Hartofikakidis. Because these systems are more frequently used, we would recommend one of them to grade the severity of osteoarthritis secondary to developmental dysplasia of the hip in adult patients instead of the ones described by Eftekhar or by Kerboul.

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Severity of hip dysplasia and loosening of the socket in cemented total hip replacement

Cited by 72 publications

References 24 publications

Poor Survival of Abg I Hip Prosthesis in Younger Patients

Poor Survival of Abg I Hip Prosthesis in Younger Patients

Reliability and validity of the Hartofilakidis classification system of congenital hip disease in adults

The Eftekhar and Kerboul classifications in assessment of developmental dysplasia of the hip in adult patients. Measurement of inter- and intraobserver reliability

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