Long-Term Results of Cemented Total Hip Arthroplasty in Developmental Dysplasia With Acetabular Bulk Bone Grafts After Improving Operative Techniques

Akiyama, Haruhiko; Kawanabe, Keiichi; Iida, Hiroya; Pan, Haile; Goto, Koji; Nakamura, Takashi

doi:10.1016/j.arth.2009.05.017

Cited by 29 publications

(15 citation statements)

References 16 publications

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“…Concerning the clinical outcomes of THA using bulk bone grafts, Goto et al [4] report the cemented cup survival rate was 98 % in 147 joints followed up for 11.8 years. Other studies also report similar good long-term results using cemented cups [25]. On the other hand, Saito et al [5] report a 94.5 % survival rate in 37 joints treated using cementless cups with bulk bone grafting that were followed up for 18.5 years, and Tsukada and Wakui [6] report a 100 % survival rate in 22 joints monitored for 8.3 years; these results are strongly corroborated by those of other similar studies [18,26].…”

Section: Discussionsupporting

confidence: 69%

Influence of cup-center-edge angle on micro-motion at the interface between the cup and host bone in cementless total hip arthroplasty: three-dimensional finite element analysis

Kaku

Tabata

Tsumura

2015

Eur J Orthop Surg Traumatol

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We verified the index cup position required for bulk bone grafting instead of morcellized grafting immediately after cementless total hip arthroplasty. Three-dimensional finite element analysis was used to evaluate changes in the volume of the slippage of the cup-host bone interface as micro-motion of the cup at the acetabular bone defect site depending on the cup-center-edge (CE) angle. The conditions of bulk bone grafts were similar to those of cortical bone. Slippage increased with decreasing cup-CE angle. A bulk bone graft tightly fixed to the host bone prevented considerably larger slippage between the cup and host bone. A smaller cup-CE angle increased the impact of the bulk bone graft on slippage. When the cup-CE angle was 0° or -10°, the criterion for slippage in favorable initial fixation in all conditions was <40 μm. Even if transplanted bulk bone is used, unless good fixation is obtained between the host bone, and the cup and bone graft, it is impossible to obtain reliable fixation of the cup with a cup-CE angle <-10° and slippage exceeding 40 μm. Bulk bone grafting tightly fixed to the host bone improves initial the cup-host bone fixation, especially when the cup-CE angle is small, such as <-10°. In clinical practice, negative factors are implicated in the initial fixation of various cups, and sufficient fixation between the host bone and cup or bulk bone graft using a screw is effective when the cup-CE angle is extremely small.

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Section: Discussionsupporting

confidence: 69%

Influence of cup-center-edge angle on micro-motion at the interface between the cup and host bone in cementless total hip arthroplasty: three-dimensional finite element analysis

Kaku

Tabata

Tsumura

2015

Eur J Orthop Surg Traumatol

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“…Cemented acetabular components have variable results in the literature. Survival ratio of the acetabular component was found 96% and 91% at 15 years with excellent long-term clinical and radiographic survivorship for acetabular dysplasia [38]. In another study with mean follow-up period of 15.7 year, the survival of the cemented acetabular component was 78%.…”

Section: Acetabular Partmentioning

confidence: 79%

Total Hip Replacement in Developmental Dysplasia of the Hip: Pitfalls and Challenges

Korkmaz¹,

Malkoç²

2017

Developmental Diseases of the Hip - Diagnosis and Management

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Introduction: Surgical treatment methods for developmental dysplasia of the hip (DDH) in the elderly patients contain pelvic or periacetabular osteotomy and hip arthroplasty. Total hip arthroplasty (THA) is the last and definitive surgical treatment modality for the end stage developmental dysplasia of the hip. Deformity classification and reconstruction:Crowe classification system describes the degree of dysplasia and gives information about the reconstruction procedure with hip arthroplasty. Classification is based on the magnitude of proximal femoral migration relative to the acetabulum. Acetabular component must be implanted to the true acetabulum for the optimal range of motion and stability of the reconstructed hip. The femoral component must be placed in neutral or slight anteversion but narrow femoral canal can be a problem for the reconstruction of femur. Conclusion-key results:The results of total hip arthroplasty in developmental dysplasia of the hip have been satisfactory for stability, mobility, and pain relief. The survivorship of cemented arthroplasty in dysplastic hips is inferior because of the young age of the patients and the complexity of the procedures. Early and midterm results of cementless hip arthroplasty are better. Most important complications after the surgery are dislocation of the reconstructed hip and sciatic nerve injury.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…Concurrently, Bobak et al [8] reported no revisions with acetabular bone graft involving 45 cemented THAs after a mean follow-up of 11 years. Akiyama et al [9] used an evolving operative technique and predicted that the acetabular component survival rate at 15 years was 96 % and 91 %, with revision for aseptic and radiological loosening as end points, respectively. The utility of bulk bone grafts for DDH remains uncontroversial, but acetabular morphology for bulk bone graft has not been discussed thus far.…”

Section: Introductionmentioning

confidence: 99%

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

Iida

Kawamura

et al. 2015

International Orthopaedics (SICOT)

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Purpose The aims of this retrospective study were to firstly introduce three practical bulk bone graft techniques based on acetabular morphology for dysplasia and secondly evaluate the long-term durability of acetabular reconstruction using those techniques combined with cemented total hip arthroplasty (THA). Methods The study comprised 101 consecutive THAs with a minimum follow-up of ten years; these procedures were categorised as being L shape (n=58), Wall (n=33) and D shape (n=10) types. Results At the last follow-up, all bone grafts acquired trabecular reorientation, and no evidence of revision for aseptic or radiological loosening was noted. Conclusions These bone graft techniques will be effective for improving the management of dysplasia in cemented THA by providing both acetabular reconstruction and cement containment.

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Long-Term Results of Cemented Total Hip Arthroplasty in Developmental Dysplasia With Acetabular Bulk Bone Grafts After Improving Operative Techniques

Cited by 29 publications

References 16 publications

Influence of cup-center-edge angle on micro-motion at the interface between the cup and host bone in cementless total hip arthroplasty: three-dimensional finite element analysis

Influence of cup-center-edge angle on micro-motion at the interface between the cup and host bone in cementless total hip arthroplasty: three-dimensional finite element analysis

Total Hip Replacement in Developmental Dysplasia of the Hip: Pitfalls and Challenges

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

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