Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip

Ding, Zichuan; Zeng, Wei‐Nan; Mou, Ping; Liang, Zhimin; Zhou, Kai

doi:10.1111/os.12665

Cited by 34 publications

(28 citation statements)

References 44 publications

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“…Regarding the limitation of the thin polyethylene liner and extremely small femoral head, standard-sized component with ceramic-on-ceramic bearing is recommended in recent studies [13,12,10]. Quantitative coverage analysis suggested that segmental de ciency located at the entire acetabular rim, excepted for the posterior direction.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of the severe dysplasia of the hip, the use of small acetabular prosthesis was recommended to achieve satisfactory bony coverage [7,8]. However, polyethylene wear and risk of postoperative dislocation have been proved to be associated with small prosthesis size [9][10][11]. Follow-up studies of high-riding DDH also showed that acetabular revision risk was signi cantly higher than femoral revision [9,11].…”

Section: Introductionmentioning

confidence: 99%

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Feasibility And Availability of Standard-Sized Cup At The True Acetabulum In Acetabular Reconstruction of Crowe Type IV Hip Dysplasia

Yang

et al. 2021

Preprint

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Background: This study aimed to investigate the morphological features and 2D/3D coverage parameters of the true acetabulum of Crowe type IV hips and to identify the optimal component center of standard-sized cup implantation.Methods: A total of 42 Crowe IV hips in 37 patients and 36 normal hips were included in the present study. Based on 3D reconstruction, anatomy and volume of the true acetabulum were measured quantitatively. Through simulated implantation, the feasibility of standard-sized cup implantation was evaluated by cup-based morphological assessments and coverage parameters. Eventually, bony landmarks for optimal component center location were determined. Mean follow-up was 4.7 years (1.2 to 6.3 years).Results: All the dysplastic hips were placed with standard-size acetabular implant (44.67mm, 44 to 48mm) successfully, with no acetabular implant loosening during the follow-up period. Compared with control group, the dysplastic acetabulum was more anteverted and abductive, with a thicker medial wall. According to the true acetabulum, bone stock is relatively sufficient in the posterior direction and prominently deficient in the anterosuperior and superior direction. Average 3D component coverage can reach 79.89% by standard-sized cup implantation at the true acetabulum. Regarding the component opening plane, the optimal component center located at the midpoint between the superolateral and posteroinferior point of the true acetabulum. Conclusion: Standard cup implantation is feasible and available in Crowe IV hip at the true acetabulum. The optimal component center was determined to be relatively constant based on the useful bony landmarks.Level of evidence: Therapeutic Level 3b.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility And Availability of Standard-Sized Cup At The True Acetabulum In Acetabular Reconstruction of Crowe Type IV Hip Dysplasia

Yang

et al. 2021

Preprint

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“…Zhou et al . reported that use of a larger femoral head and improved abductor muscle strength could help reduce the rate of postoperative dislocation 43 . A 28‐mm ceramic femoral head was used in all the bilateral Crowe type IV DDH following the method we introduced.…”

Section: Discussionmentioning

confidence: 99%

“…Zhou et al reported that use of a larger femoral head and improved abductor muscle strength could help reduce the rate of postoperative dislocation. 43 A 28-mm ceramic femoral head was used in all the bilateral Crowe type IV DDH following the method we introduced. Due to the morphologic abnormalities in the acetabulum and the femur, placing the prosthesis at an ideal location is difficult and soft tissue balance is necessary.…”

Section: Postoperative Complications In Crowe Type IV Developmental Dmentioning

confidence: 99%

One‐Stage Total Hip Arthroplasty with Modular S‐ROM Stem for Patients with Bilateral Crowe Type IV Developmental Dysplasia

Lü

Sun

et al. 2020

Orthopaedic Surgery

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The aim of the present paper was to evaluate the results of one-stage total hip arthroplasty (THA) for patients with bilateral Crowe type IV developmental dysplasia of the hip (DDH). Methods: Data for 58 patients (116 hips) with bilateral Crowe type IV DDH who had one-stage THA performed by the same surgeon during the period of April 2008 to February 2019 were retrospectively reviewed. The mean age of the patients was 37.3 years; 5 were men and 53 were women. All patients underwent THA through the posterolateral approach using the Pinnacle acetabular cup, a ceramic-on-ceramic bearing, and the modular S-ROM stem. Subtrochanteric shortening osteotomy was performed on 86/116 hips. Intraoperative conditions were recorded. Radiographic and functional outcomes were evaluated, and complications were recorded. Results: All patients were followed up for an average of 71.3 ± 37.6 months (range, 12-140). The mean operative time was 276.5 ± 57.9 min (range, 175-540). The mean intraoperative blood loss was 933.6 ± 400.8 mL (range, 300-2000). The mean transfusion requirement was 1778 ± 798.0 mL (range, 575-4550). The mean length of hospital stay was 8.6 ± 3.7 days (range, 5-22). At the final follow-up, no loosening of acetabular and femoral components was observed. No osteolysis and heterotopic ossification occurred. The mean Harris hip scores were improved from 55.4 ± 14.3 preoperatively to 91.3 ± 4.2 postoperatively (P < 0.001) In terms of complications, no perioperative deaths were recorded. Deep vein thrombosis occurred in 1 hip, with no pulmonary embolism. Intraoperative femur fracture occurred in 3 hips, nerve injury in 1 hip, and leg length discrepancy in 1 patient. Postoperative dislocation occurred in 5 hips and nonunion in 1 hip. Conclusion: Our data demonstrated that one-stage bilateral THA for bilateral Crowe type IV DDH is feasible and can effectively restore hip function.

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“…Rates of intraoperative fracture, postoperative dislocation, and nerve injury were 2.7%, 4.8%, and 1.1%, respectively. Previous studies [ 18 – 22 ] have reported intraoperative fracture rates as high as 28%, postoperative dislocation rates ranging from 1% to 17%, and nerve injury rates of approximately 10%. These comparisons indicate that the decision-making in the present study was appropriate and can be used as the basis for establishing a predictive model.…”

Section: Discussionmentioning

confidence: 99%

Model to Predict Need for Subtrochanteric Shortening Osteotomy During Total Hip Arthroplasty for Crowe Type IV Developmental Dysplasia

Sun

et al. 2020

Med Sci Monit

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Background Indications for subtrochanteric shortening osteotomy (SSOT) during Crowe type IV developmental dysplasia of the hip (DDH) are unclear. The aim of this retrospective study was to create a model to predict the need for performing SSOT. Material/Methods One hundred forty-nine patients (186 hips) with Crowe Type IV DDH who underwent total hip arthroplasty (THA) with S-ROM implants from January 2010 to November 2018 were included in the study. The acetabular components were placed at the true acetabulum and the trial femoral component was inserted. Reduction then was attempted and if it could not be achieved, SSOT was performed. Using multivariable Cox regression analysis, a model was constructed that included age, sex, surgical history, use of a cone- or triangle-shaped sleeve, secondary acetabulum formation, and percentage of dislocation as predictive factors for SSOT. Results SSOTs were performed on 140 of 186 hips. Secondary acetabulum formation was present in 27 hips (58.70%) in which SSOT was not performed 7 (5.00%) in which it was performed. Cone-shaped sleeves were used in 17 hips (36.96%) in which SSOT was not performed versus 15 (10.71%) hips in which it was performed. Dislocation occurred in 31.30±5.80% hips in which SSOT was performed versus 24.05±4.39% of those in which it was not performed. Percentage of dislocation was associated with an increased likelihood of SSOT (odds ratio [OR] 1.24, 95% confidence interval 1.11–1.38), whereas secondary acetabulum formation (OR 0.10, 0.03–0.33) and use of a cone-shaped sleeve (0.18, 0.06–0.53) were associated with decreased likelihood of SSOT. We established a model for prediction of SSOT with a nanogram and the discriminative ability (C statistic) of it was 0.918 (0.79–0.92). Conclusions Factors that significantly affect likelihood of performing an SSOT were identified and a model with significant ability to predict the need for SSOT in patients with Crowe Type IV DDH was created.

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Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip

Cited by 34 publications

References 44 publications

Feasibility And Availability of Standard-Sized Cup At The True Acetabulum In Acetabular Reconstruction of Crowe Type IV Hip Dysplasia

Feasibility And Availability of Standard-Sized Cup At The True Acetabulum In Acetabular Reconstruction of Crowe Type IV Hip Dysplasia

One‐Stage Total Hip Arthroplasty with Modular S‐ROM Stem for Patients with Bilateral Crowe Type IV Developmental Dysplasia

Model to Predict Need for Subtrochanteric Shortening Osteotomy During Total Hip Arthroplasty for Crowe Type IV Developmental Dysplasia

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