Periacetabular Osteotomy for Containment of the Nonarthritic Dysplastic Hip Secondary to Poliomyelitis

Sierra, Rafael J.; Schoeniger, Sandra; Millis, Michael B.; Ganz, Reinhold

doi:10.2106/jbjs.i.00753

Cited by 15 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Routine radiographs comprising an anteroposterior view of the pelvis as well as anteroposterior and lateral views of the affected hip were performed and compared to the initial postoperative radiographs. Radiographs were evaluated by two fellowship-trained hip arthroplasty surgeons (MD and NR) for evidence of biological fixation (using the fixation/stability score of Engh [17]), subsidence (as described by Pelligrini et al [18]), osteolysis (based on Gruen modes of failure [19]), and heterotopic ossification (graded according to Brooker’s classification [20]).…”

Section: Methodsmentioning

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

View full text Add to dashboard Cite

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

show abstract

Section: Methodsmentioning

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

View full text Add to dashboard Cite

show abstract

“…However, longer follow-up is necessary to make categorical conclusions about the progression of osteoarthritis as these patients age and muscular imbalances remain. 32 Although it is difficult to draw general conclusions with only 6 patients, this study showed acceptable long-term clinical outcomes, with a marked decrease in VAS pain score after THA in the ipsilater-al hip of patients with muscle strength of at least M3 motor power of hip abductors. Similarly, pain and knee scores showed improvement after total knee arthroplasty in poliomyelitic limbs with at least antigravity quadriceps strength, with worse outcomes reported in patients with less than antigravity quadriceps strength and postpoliomyelitic syndrome or severe preoperative knee hyperextension.…”

Section: Discussionmentioning

confidence: 64%

“…These authors concluded that restoration of the femoroacetabular anatomy is crucial to counterbalance muscular atony. Lee et al, 30 Lin et al, 31 and Sierra et al 32 reviewed their experience with periacetabular osteotomy to stabilize both nonparalytic and paralytic postpolio hips of young adults and reported substantial improvement in muscle strength and acetabulum head quotient as well as normalization of the center-edge angle. However, longer follow-up is necessary to make categorical conclusions about the progression of osteoarthritis as these patients age and muscular imbalances remain.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis

Buttaro¹,

Slullitel²,

García-Mansilla³

et al. 2017

Orthopedics

View full text Add to dashboard Cite

Incapacitating articular sequelae in the hip joint have been described for patients with late effects of poliomyelitis. In these patients, total hip arthroplasty (THA) has been associated with a substantial rate of dislocation. This study was conducted to evaluate the long-term clinical and radiologic outcomes of unconstrained THA in this specific group of patients. The study included 6 patients with ipsilateral polio who underwent primary THA between 1985 and 2006. Patients with polio who underwent THA on the nonparalytic limb were excluded. Mean follow-up was 119.5 months (minimum, 84 months). Clinical outcomes were evaluated with the modified Harris Hip Score (mHHS) and the visual analog scale (VAS) pain score. Radiographs were examined to identify the cause of complications and determine the need for revision surgery. All patients showed significantly better functional results when preoperative and postoperative mHHS (67.58 vs 87.33, respectively; P=.002) and VAS pain score (7.66 vs 2, respectively; P=.0003) were compared. Although 2 cases of instability were diagnosed, only 1 patient needed acetabular revision as a result of component malpositioning. None of the patients had component loosening, osteolysis, or infection. Unconstrained THA in the affected limb of patients with poliomyelitis showed favorable long-term clinical results, with improved function and pain relief. Nevertheless, instability may be a more frequent complication in this group of patients compared with the general population. [Orthopedics. 2017; 40(2):e255-e261.].

show abstract

“…Even though management of bony abnormalities in this population has been attempted with conservative surgeries to prevent degenerative changes and restore coverage of the femoral head in nonarthritic dysplastic hips (30), many patients ultimately require THR.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Total Hip Replacement in Limbs Affected by Poliomyelitis

et al. 2016

View full text Add to dashboard Cite

show abstract

Periacetabular Osteotomy for Containment of the Nonarthritic Dysplastic Hip Secondary to Poliomyelitis

Cited by 15 publications

References 12 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

Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis

Outcomes of Total Hip Replacement in Limbs Affected by Poliomyelitis

Contact Info

Product

Resources

About