Total hip replacement for developmental dysplasia of the hip: How I do it

Paavilainen, Timo

doi:10.3109/17453679709003983

Cited by 42 publications

(32 citation statements)

References 20 publications

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“…The associated anatomical deformities of the hip include hypoplastic acetabulum and deformity of the proximal femur [1–3, 7–9]. If not diagnosed and adequately treated during childhood, DDH may lead to early functional impairment and anatomical alterations of the hip joint in young adults [1].…”

Section: Discussionmentioning

confidence: 99%

“…Especially in some Asian DDH patients with a small physique, the femur usually presents with a short skeleton and an excessive narrow canal [6]. Total hip arthroplasty (THA) is technically difficult in such small-proportioned patients because most conventional cemented or cementless femoral components are often difficult to implant in the narrow femoral canal and require slight version correction of the femoral stem [6–9]. …”

Section: Introductionmentioning

confidence: 99%

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Developmental hip dysplasia treated by total hip arthroplasty using a cementless Wagner cone stem in young adult patients with a small physique

Peng

Lü

et al. 2017

BMC Musculoskelet Disord

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BackgroundDevelopmental hip dysplasia (DDH) may lead to severe acetabular and femoral abnormalities that can render total hip arthroplasty (THA) challenging, especially in DDH patients with a small physique. Most conventional cemented or cementless femoral components are often difficult to implant in the narrow femoral canal and require slight version correction during surgery. The aim of this study was to present the mid-term results of THA in the treatment of DDH patients with a small physique using a cementless Wagner cone prosthesis (Zimmer®, US).MethodsBetween January 2006 and March 2010, we retrospectively reviewed 50 patients who were treated at our center. A total of 50 patients (52 hips; 45 women, five men; mean age 32.5 years; range 27 to 38 years) who underwent THA were observed. The mean femoral medullary canal dimension at the isthmus was 7.6 mm (range 6.0 to 8.7). According to the Crowe classification, 19 hips presented dysplasia of grade I, while 33 presented dysplasia of grade II. All patients were treated with THA using a cementless Wagner cone prosthesis. Clinical and radiologic evaluations were performed on all patients.ResultsThe mean duration of follow-up was 7.7 years (range 5.4 to 10.5). The Harris hip score (HHS) improved from 63 ± 9 (range 55 to 70) pre-operatively to 92 ± 8 (range 88 to 100) at the last follow-up. The HHS at the most recent follow-up was excellent in 66% of patients (34 hips), good in 26% (14 hips), fair in 6% (3 hips), and poor in 2% (1 hip). Radiographic evaluation demonstrated excellent osteointegration of the implants. Stem subsidence was present in three stems, and the range of stem subsidence was 2 mm in two stems (3.9%) and 3 mm in one stem (1.9%). Femoral osteolysis was observed in nine hips (18%) in the proximal zones, and no distal osteolysis was noted. Heterotopic ossification was observed in three hips (5.8%); of these, two were classified as Brooker’s grade 1, and one was classified as Brooker’s grade 2 at the most recent follow-up. None of the implants were revised.ConclusionsBased on the tapered shape and free setting of anteversion, the Wagner cone femoral stem facilitates its implantation in dysplastic hips. Therefore, this series of short stems with a smaller diameter can ensure safe implantation in narrow medullary canals, especially in young DDH patients with a small physique.Trial registrationRegistration Number: ChiCTR-ORC-17011181.Reg Date: 2017-04-19 00:44:59Retrospective registration

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developmental hip dysplasia treated by total hip arthroplasty using a cementless Wagner cone stem in young adult patients with a small physique

Peng

Lü

et al. 2017

BMC Musculoskelet Disord

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“…Biomechanical investigations have shown that loads on the hip can be reduced by placing the acetabular component medially, inferiorly and anteriorly (Johnston et al 1979). Nevertheles, in patients with hip dysplasia, most authors advocate an anatomical or slightly higher cup position at the level of maximal thickness of available acetabular bone (Harris and Crothers 1976, Johnston et al 1979, Garvin et al 1991, Paavilainen 1997.…”

Section: Discussionmentioning

confidence: 99%

Structural bone grafting in arthroplasty for congenital hip dysplasia: 35 hips followed for 5-10 years

Becker¹,

Urbach²,

Grasshoff³

et al. 1999

Acta Orthopaedica Scandinavica

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“…Survivorship of new generation alumina ceramic bearings at end of 10 years was more than metal on polyethylene bearing surfaces. These materials are biocompatible, wet-table, high-strength, provide superior lubrication and wear resistance and can yield good surface finishes [11]. Thus, the ceramic femoral head and acetabular cup may be a good choice for the younger patient in whom it seems necessary to use a larger head for stability reasons.…”

Section: Discussionmentioning

confidence: 99%

“Newer Bearing Surface Total hip arthroplasty in Developmental Dysplasia of hip”

Jain¹,

Pathak²,

Kalaivanan³

2013

IOSR-JDMS

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Total hip replacement for developmental dysplasia of the hip: How I do it

Cited by 42 publications

References 20 publications

Developmental hip dysplasia treated by total hip arthroplasty using a cementless Wagner cone stem in young adult patients with a small physique

Developmental hip dysplasia treated by total hip arthroplasty using a cementless Wagner cone stem in young adult patients with a small physique

Structural bone grafting in arthroplasty for congenital hip dysplasia: 35 hips followed for 5-10 years

“Newer Bearing Surface Total hip arthroplasty in Developmental Dysplasia of hip”

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