Total hip replacement with a superolateral bone graft for osteoarthritis secondary to dysplasia

Abstract

We evaluated the long-term results of 116 total hip replacements with a superolateral shelfplasty in 102 patients with osteoarthritis secondary to developmental dysplasia of the hip. After a mean follow-up of 19.5 years (11.5 to 26.0), 14 acetabular components (12%) had been revised. The cumulative survival at 20 years was 78%, with revision for loosening of the acetabular component as the end-point. All grafts were well integrated and showed remodelling. In six grafts some resorption had occurred under the heads of the screws where the graft was not supporting the socket. Apart from these 14 revisions, seven acetabular components had possible radiological signs of loosening at a mean follow-up of 14.5 years, one had signs of probable loosening, and five had signs of definite loosening. These results indicate that this technique of bone grafting for acetabular reconstruction in hip dysplasia is a durable solution for cemented acetabular components.

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

“…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.…”

Favorable Survival of Acetabular Reconstruction With Bone Impaction Grafting in Dysplastic Hips

“…Most surgeons will use a technique with a superolateral structural graft, which yields satisfying early to mid-term results both with cemented and uncemented cup placement [4,9,16,17,27,32,36,38]. However, long-term experience with acetabular reconstructions with these bulk structural grafts has been reported with variable results [27,32,44].…”

Long-term results of acetabular reconstruction using three bulk bone graft techniques in cemented total hip arthroplasty for developmental dysplasia

“…Many authors report excellent results of bulk bone graft for DDH in cemented THA [6,8,9,[20][21][22][23], and survivorship for revision of aseptic and radiological loosening is reported to be 85-100 % and 82-100 %, respectively, during a minimum follow-up of ten years. Zahar et al [24] reported that although the midterm functional outcome of THA with acetabular bulk bone graft was satisfactory, long-term results were questionable, so the good results reported may depend on meticulous technique.…”