Bilateral High Hip Center Provides Gait Parameters Similar to Anatomical Reconstruction: A Gait Analysis Study in Hip Replacement Patients With Bilateral Developmental Dysplasia

Karaismailoğlu, Bedri; Kaynak, Gökhan; Can, Ata; Özşahin, Mahmut Kürşat; Erdoğan, Fahri

doi:10.1016/j.arth.2019.06.063

Cited by 19 publications

(30 citation statements)

References 39 publications

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“…In this study, except for the 48-mm and 50-mm cups, other cups achieved the mean CC of greater than 90% after elevating from true acetabulum. Many studies have shown that HHC technique does not cause aseptic loosening of cups, and the outcomes after medium and long-term follow-ups are satisfactory 23,[25][26][27][28] . Therefore, we believe that the HHC technique is a valid method to reconstruct acetabulum for DDH patients.…”

Section: Discussionmentioning

confidence: 99%

A New Method to Evaluate Acetabular Bone Defect in Patients With Crowe Type Ⅱ and Type Ⅲ Developmental Dysplasia of the Hip: Acetabular Reconstruction Based on Three-dimensional Reconstruction Images

Wen¹,

Zuo²,

Liu³

et al. 2021

Preprint

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This study evaluated the cup coverage(CC) of acetabular cup models with different sizes in patients with Crowe type Ⅱ and type Ⅲ DDH by the high hip center technique(HHC), the results shows that the CC of cup sizes with 38mm, 40mm, 42mm, 44mm, 46mm, 48mm, and 50 mm increased by 21.24%, 21.58%, 20.86%, 20.04%, 18.62%, 17.18%, and 15.42% (P<0.001) respectively as the cups elevated from the true acetabula until the maximum coverage were achieved. What surprising is the mean CC at the true acetabula were 77.85%, 76.71%, 75.73%, 74.56%, 73.68%, 72.51%, and 71.75%, respectively. So, we draw a distribution frequency map of uncovered portion of all 44-mm cups at the true acetabula to illustrate the distribution of bone defects of the acetabulum. The map shows that 95% of type Ⅱ and type Ⅲ DDH acetabula had bone defects in posterosuperior, and 60% were located outside the force line of the hip joint.Here comes to a conclusion that acetabular cups can meet the CC of more than 70% at the true acetabulum, and 60% of Crowe type Ⅱ and type Ⅲ DDH patients can obtain satisfactory CC at the true acetabulum by using a 44-mm cup without additional operation.

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Section: Discussionmentioning

confidence: 99%

A New Method to Evaluate Acetabular Bone Defect in Patients With Crowe Type Ⅱ and Type Ⅲ Developmental Dysplasia of the Hip: Acetabular Reconstruction Based on Three-dimensional Reconstruction Images

Wen¹,

Zuo²,

Liu³

et al. 2021

Preprint

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“…At present, whether the hip rotation center in THA for Crowe type III DDH should be anatomically restored or highly restored is still controversial. Many scholars[ 7 8 9 10 ] recommended high restoration, because the host bone coverage rate of acetabular prosthesis could reach 70%, thus increasing the initial stability and promoting bone in-growth. Long-term stability of the acetabular prosthesis could be achieved with bone integration, but surgical procedures could be simplified.…”

Section: Discussionmentioning

confidence: 99%

Novel 3D printed integral customized acetabular prosthesis for anatomical rotation center restoration in hip arthroplasty for developmental dysplasia of the hip crowe type III

et al. 2020

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Rationale: Exact restoration of the rotation center in total hip arthroplasty (THA) is technically challenging in patients with end-stage osteoarthritis due to developmental dysplasia of the hip (DDH), especially in the Crowe type II and III procedures. The technical difficulty is attributable to the complex acetabular changes. In this study, a novel 3-dimensional (3D) printed integral customized acetabular prosthesis for anatomical rotation restoration in THA for DDH Crowe type III was developed using patient-specific Computer-aided design and additive manufacturing (AM) methods. Patient concerns: A 69-year-old female patient had developed left hip joint pain and restricted movement for 40 years; the symptoms had increased in the past 5 months. Pain, limited motion of the left hip joint, and lower limb length discrepancy were noted during physical examination. Diagnosis: The patient was diagnosed with left hip end-stage osteoarthritis secondary to DDH (Crowe type III). Intervention: A 3D printed acetabulum model was manufactured and a simulated operation was performed to improve the accuracy of reconstruction of the rotation center and bone defect. A 3D printed titanium alloy integral customized acetabular prosthesis was designed according to the result of simulated operation. The integral customized prothesis was implanted subsequently via the posterolateral approach. Radiography of the pelvis and Harris score assessment were performed during the perioperative period as well as at the 6- and 12-month follow-up. Outcomes: The 3D printed integral customized acetabular prosthesis matched precisely with the reamed acetabulum. The rotation center was restored and the bone defect was exactly reconstructed. There were no signs of prosthetic loosening at the 12-month follow-up. The Harris score gradually improved during the follow-up period. Lessons: Satisfactory results of hip rotation restoration and bone defect reconstruction could be achieved by using 3D printed integral customized acetabular prosthesis, which provides a promising way to reconstruct the acetabulum in patients with DDH anatomically and rapidly for THA.

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“…We try to perform acetabular reconstruction in true acetabulum position during surgery; in some cases, we preferred high hip center reconstruction due to patient's condition and risks encountered during surgery. Karaismailoglu et al [24] recently reported that there is no difference between high hip center reconstruction and anatomical hip center reconstruction regarding the gait analysis and high hip center reconstruction may be used during severe cases with the surgeon's preference and the patient's benefit.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of total hip arthroplasty in developmental dysplasia of hip patients

2020

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Developmental dysplasia of hip (DDH) is one of the well-known orthopedic pathologies that cause coxarthrosis. [1] Pelvic bandage, traction, open or closed reduction, femoral, and pelvic osteotomies are the treatment alternatives for DDH in the pediatric age group. [2,3] For end-stage osteoarthritis, total hip arthroplasty (THA) is the standard treatment. [4,5] In the literature, several studies have reported that the anatomical hip center reconstruction yields favorable biomechanical results among those patients. [6,7] Both acetabular and femoral abnormal anatomy make this re-establishment challenging for surgeons. Among those patients, complication rates are higher than the normal arthroplasty operations due to the pathological anatomy. In DDH patient population, changing abnormal anatomy to normal and to reduce complication rates and prolong prosthesis survival, specially designed implants are needed. In this study, we aimed to report the physiological and radiological long-term results of THA combined with or without subtrochanteric osteotomy in a group of DDH patients. PATIENTS AND METHODS A total of 90 hips of 59 patients (3 males, 56 females; mean age 45.7±10.9 years; range, 24 to 67 years) who Objectives: This study aims to report the physiological and radiological long-term results of total hip arthroplasty (THA) combined with or without subtrochanteric osteotomy in a group of developmental dysplasia of hip (DDH) patients. Patients and methods: This retrospective study included 90 hips of 59 patients (3 males, 56 females; mean age 45.7±10.9 years; range, 24 to 67 years) who underwent THA between January 1979 and March 2006. Thirteen patients needed subtrochanteric shortening. The evaluation was performed through Harris hip scores, physical examination, and radiological imaging. Results: The follow-up period ranged from 5 to 32 years, and the mean follow-up period was 10.3±6.4 years. Revision was required in 17 hips out of 90. Twelve revisions were needed because of aseptic loosening of femoral or acetabular component, three were for fracture of the femoral stem, and two for protrusio acetabuli. Four patients had transient nerve palsy, and one had permanent nerve function loss. In one patient, nonunion was observed around the femoral osteotomy site. Harris hip score was remarkably improved compared to top preoperative values (48 vs. 88.2, p<0.01). Conclusion: Although revision rates tend to increase in long-term follow-up, THA is one of the best treatment options in DDH patients to relieve pain, improve daily activity levels, and minimize the damage of the knee and lumbar region.

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Bilateral High Hip Center Provides Gait Parameters Similar to Anatomical Reconstruction: A Gait Analysis Study in Hip Replacement Patients With Bilateral Developmental Dysplasia

Cited by 19 publications

References 39 publications

A New Method to Evaluate Acetabular Bone Defect in Patients With Crowe Type Ⅱ and Type Ⅲ Developmental Dysplasia of the Hip: Acetabular Reconstruction Based on Three-dimensional Reconstruction Images

A New Method to Evaluate Acetabular Bone Defect in Patients With Crowe Type Ⅱ and Type Ⅲ Developmental Dysplasia of the Hip: Acetabular Reconstruction Based on Three-dimensional Reconstruction Images

Novel 3D printed integral customized acetabular prosthesis for anatomical rotation center restoration in hip arthroplasty for developmental dysplasia of the hip crowe type III

Long-term results of total hip arthroplasty in developmental dysplasia of hip patients

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