Use of an offset head center acetabular shell in difficult primary total hip arthroplasties

Wassef, Andrew J.; Khlopas, Anton; Sodhi, Nipun; Sultan, Assem A.; Piuzzi, Nicolás S.; Chughtai, Morad; Stearns, Kim L.; Molloy, Robert; Mont, Michael A.

doi:10.21037/atm.2018.09.11

Cited by 2 publications

(2 citation statements)

References 19 publications

(17 reference statements)

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“…Total hip arthroplasty (THA) is usually the preferred treatment for pain and end-stage osteoarthritis, secondary to developmental dysplasia of the hip (DDH) in adult patients (1,2). Accurate preoperative planning and precise execution of that planning during THA are crucial (3).…”

Section: Introductionmentioning

confidence: 99%

Patient-specific total hip arthroplasty is superior to conventional methods for Crowe III and IV adult developmental hip dysplasia: a randomized controlled trial

Wang¹,

Li²,

Hu³

et al. 2021

Ann Transl Med

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Background: Restoration of the acetabulum during total hip arthroplasty in adults with developmental dysplasia of the hip (DDH-THA) and resumption of hip function remain major challenges. Herein, a new patient-specific instrument (PSI) was developed that uses the superolateral rim of the acetabulum as a positioning marker to assist surgeons in adult DDH-THA.Methods: From January 2017 to October 2018, 104 adult DDH patients were randomized to either the PSI group or conventional operation (CO) group, and further divided into eight subgroups by stratified random sampling using Crowe's classification. Complications, Harris hip scores (HHS), and X-ray results were recorded at 3 and 12 months after surgery.Results: With the exception of anteversion in CO-Crowe II group patients, there was no difference in the accuracy of cup placement and orientation between the PSI and CO groups in Crowe I and II DDH patients.With the exception of percentage of acetabular cup coverage (PACC) and the qualification rate of Crowe IV PACC patients, among all Crowe III and IV DDH groups, all postoperative indexes of cup orientation and positioning exhibited significant differences between the PSI and CO groups; however, no significant differences were observed in Crowe I and II DDH patients.Conclusions: Compared with conventional methods, the new PSI-assisted surgical method improved the accuracy of placement and orientation of the acetabulum and cup prosthesis, optimized the surgical process, reduced complications, and contributed to quicker recovery of hip function after surgery in adults with Crowe III and IV DDH-THA, but little difference was noted for those with Crowe I and II DDH.

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Section: Introductionmentioning

confidence: 99%

Patient-specific total hip arthroplasty is superior to conventional methods for Crowe III and IV adult developmental hip dysplasia: a randomized controlled trial

Wang¹,

Li²,

Hu³

et al. 2021

Ann Transl Med

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“…Developmental dysplasia of the hip (DDH) is a common bone and joint deformity in infants. Early diagnosis and treatment can effectively prevent claudication, femoral head necrosis, and even limb disability (1)(2)(3). Those who are positive for physical examination or have high risk factors for DDH (breech birth, positive family history, etc.)…”

Section: Introductionmentioning

confidence: 99%

Ultrasound features predicting the 3-week outcome of Pavlik harness treatment for developmental hip dysplasia

Xu¹,

Yang²,

Xu³

et al. 2020

Ann Palliat Med

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Background:The treatment protocol for children with developmental dysplasia of the hip (DDH) is routinely adjusted by assessing the hip reduction after 3 weeks of Pavlik harness treatment. However, there is a high risk of failure and complications in the treatment adjustment. The aim of this study was to explore the value of ultrasound features in predicting the treatment outcome of Pavlik harness after 3 weeks in DDH children. Methods: A total of 215 DDH children were recruited and the demographics and the changes of ultrasound features [α and β angle and femoral head coverage (FHC)] during the Pavlik harness treatment were recorded. The children were divided into the success group and the failure group according to the reduction outcome after 3 weeks. Univariate and multivariate analyses were performed to analyze the independent predictors for the treatment outcome. Repeated-measures analysis of variance was used to compare the changes of ultrasound features between the two groups during the treatment. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive accuracy of the ultrasound features. Results: Graf type III (P=0.036), bilateral dislocation (P=0.031), and age at diagnosis (P=0.021) were associated with an increased risk of Pavlik harness failure in the multivariate analysis. The changes in α and β angle and FHC were generally greater in the success group than in the failure group. The α angle and FHC were larger in the success group, while the β angle was larger in the failure group (P<0.05). Each ultrasound parameter (α and β angle and FHC) alone could not accurately predict the treatment outcome within 3 weeks. However, the combined ultrasonic features at the second week could accurately predict the outcome of Pavlik harness treatment after the third week. The combination of the ultrasound features at the first week and the influencing factors (Graf classification, age at diagnosis, and side of pathology) could accurately predict the outcome at the first week [area under curve (AUC) =0.931, sensitivity =82.14%, specificity =97.86%].Conclusions: The combined model of ultrasonic features at the second week could accurately predict the reduction outcome of Pavlik harness after the third week. The combined model including independent predictors and ultrasonic features could accurately predict the reduction outcome at the first week.

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Use of an offset head center acetabular shell in difficult primary total hip arthroplasties

Cited by 2 publications

References 19 publications

Patient-specific total hip arthroplasty is superior to conventional methods for Crowe III and IV adult developmental hip dysplasia: a randomized controlled trial

Patient-specific total hip arthroplasty is superior to conventional methods for Crowe III and IV adult developmental hip dysplasia: a randomized controlled trial

Ultrasound features predicting the 3-week outcome of Pavlik harness treatment for developmental hip dysplasia

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