Total hip arthroplasty with a sliding iliac graft for acetabular dysplasia

Ikeuchi, Masahiko; Kawakami, Toru; Kitaoka, Kenichi; Okanoue, Yusuke; Tani, Tohru

doi:10.1302/0301-620x.87b5.15427

Cited by 12 publications

(14 citation statements)

References 33 publications

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“…The complication rate in our series is comparable with that reported in other studies of THA for dysplastic hips [17][18][19][20][21][22][23]. Limb length discrepancy is one of the main problems in severely dysplastic hip replacement, since functional lengthening is limited by tight soft tissues, especially by the sciatic nerve.…”

Section: Discussionsupporting

confidence: 85%

Long-term results of cementless anatomic total hip replacement in dysplastic hips

Bruzzone¹,

Russa²,

Garzaro³

et al. 2009

Musculoskelet Surg

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This perspective study analyzes the long-term outcomes of cementless anatomic total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Between 1990 and 2004, 100 ABG total hip prosthesis were implanted in 87 patients with DDH. The average follow-up was 9 years (range 4-18 years). The mean Harris Hip Score was 87.13 (SD = 14.6) at the last follow-up. Radiographic analysis showed good results for the stems, while in 38% of the hips we recorded periacetabular bone resorption. Mean linear polyethylene wear was 0.23 mm/year. Ten revisions have been performed, survival rate was 99% for the stems and 90% for the cups. Cementless THA with hemispherical cup and anatomical stem is recommended when possible for patients with DDH although high rates of polyethylene wear and subsequent osteolysis have been the limiting factor in the long-term success of this implant.

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Section: Discussionsupporting

confidence: 85%

Long-term results of cementless anatomic total hip replacement in dysplastic hips

Bruzzone¹,

Russa²,

Garzaro³

et al. 2009

Musculoskelet Surg

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“…Some of these methods include proximally placed small acetabular cups, placement of the cup by penetration of the medial wall (medial protrusion technique), iliac bone sliding grafting, and lateral bulk grafting using an autograft or an allograft. [5][6][7]12,[17][18][19][20] In our technique; first, we found the true acetabulum, which is very important regarding biomechanics, and then we decorticated the defect in the superolateral acetabulum until the cancellous bone was reached. We cut the femoral head in two, determined the location of the graft, and held it in the smallest volume with enough graft size; thus eliminating large volume graft problems.…”

Section: Discussionmentioning

confidence: 99%

“…Previous publications have reported that graft stability and graft-bone contact are two of the most critical factors for graft incorporation. [2,9,10,20] In the original description by Harris, [2] the femoral head is curved to fit the ilium, and a notch is made in the ilium where the femoral head is placed. Subsequently, other authors have proposed cutting the femoral head to provide cancellous bone contact.…”

Section: Discussionmentioning

confidence: 99%

Stepped osteotomy of femoral head autograft for acetabular reconstruction in total hip arthroplasty for dysplasia of the hip: 3 to 12 years’ results

et al. 2020

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This study aims to describe a stepped osteotomy technique applied to the femoral head autograft to keep the graft volume at a sufficient level, provide primary stability, and direct cancellous-cancellous bone contact. Patients and methods: In this retrospective study, 24 hips of 20 patients (5 males, 15 females; mean age 53 years; range, 43 to 68 years) with dysplasia of the hip (DDH) who underwent total hip arthroplasty with femoral head stepped osteotomy technique were evaluated between April 2003 and June 2010. Patients' age, gender, operation side, and postoperative complications were recorded. Aseptic loosening of the acetabular cup and graft integration/resorption were evaluated radiographically. Radiological evaluations were performed according to the methods of DeLee and Charnley, and Mulroy and Harris. Functional status of the patients was determined according to the criteria of Merle d'Aubigné and Postel, and Harris hip score (HHS). Results: The mean follow-up period was 5.5 years (range, 3 to 12 years). None of the patients had any complications in the early postoperative period. In all patients, the percentage of acetabular component coverage by the graft was measured as 27% (range, 19 to 38%) on average. At the last follow-up, all patients were satisfied with the result and there was no sign of clinically loosening, osteointegration was complete, and there was no radiographic evidence of graft resorption or collapse of any hip. The overall Merle d'Aubigné scores and HHSs of the patients significantly improved at the final follow-up. Conclusion: This stepped osteotomy technique increases the probability of osteointegration, reduces the need for early revision, and provides reliable stability with satisfactory clinical and radiological midterm results.

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“…One of the most important aspects is the reconstruction of the supero-lateral defect of the acetabulum. [1][2][3][4][5] During the development of the Intraosseal Structural Graft (ISG) technique our research group also worked on the surgical instruments required during the operation. During the procedure in the cranial quadrant of the acetabulum a proximally hinged cortico-spongious plate is fashioned that is opened laterally and a wedge shaped graft made from the femoral head is impacted.…”

Section: Introductionmentioning

confidence: 99%

Instrument development for acetabular roof plasty in case of dysplastic acetabular replacement

Szabó¹,

Manó²,

Lőrincz³

et al. 2012

Biomech Hung

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The authors report on the development of special surgical instruments required for the new Intraosseal Structural Graft (ISG) technique in case of dysplastic acetabular replacement presently under introduction at our Institute. One of novelties of procedure is the development of a proximally hinged cortico-spongious plate in the cranial quadrant of the acetabulum that is opened laterally.The instruments were developed, tested, and modifi ed based on experiments on 14 3D models and 19 cadaver hips. For the cortico-spongious plate a 1 and 3 step method was developed and the prototypes of the chisels required were made. The open the bone block laterally a threaded device was planned and developed. Based on the experiments the 1 step method was discarded, because the device used for opening the bone block laterally proved diffi cult, and so it was not further developed. The instruments required for the 3 step method was fi nalized and since than 2 successful operations were performed with them. With the aid of these special surgical instruments the ISG technique is easier, quicker and safer to perform.

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Total hip arthroplasty with a sliding iliac graft for acetabular dysplasia

Cited by 12 publications

References 33 publications

Long-term results of cementless anatomic total hip replacement in dysplastic hips

Long-term results of cementless anatomic total hip replacement in dysplastic hips

Stepped osteotomy of femoral head autograft for acetabular reconstruction in total hip arthroplasty for dysplasia of the hip: 3 to 12 years’ results

Instrument development for acetabular roof plasty in case of dysplastic acetabular replacement

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