Total Hip Arthroplasty in Patients with Dwarfism

Chiavetta, John B.; Parvızı, Javad; Shaughnessy, William J.; Cabanela, Miguel E.

doi:10.2106/00004623-200402000-00012

Cited by 46 publications

(58 citation statements)

References 18 publications

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“…Initially, soft tissue releases and corrective pelvic or femoral osteotomies may improve joint congruity, stability, and alignment [32]. When painful osteoarthritis (OA) develops, a THA usually relieves pain and restores function [8,19,23,33]. This is a technically challenging procedure with a high complication rate owing to the abnormal features of the hip, especially on the femoral side, in addition to bone deformity and soft tissue contracture [31].…”

Section: Introductionmentioning

confidence: 99%

“…This is a technically challenging procedure with a high complication rate owing to the abnormal features of the hip, especially on the femoral side, in addition to bone deformity and soft tissue contracture [31]. Intraoperative femoral shaft fractures or perforation are common and there is a high revision rate for aseptic loosening [8,10,12,19,25,29]. The use of custom and modular hip implants, cemented and cementless, has been advocated [1,12,13,16,25,33,34].…”

Section: Introductionmentioning

confidence: 99%

“…The midterm and long-term survival of modular femoral components are largely unknown. In patients with severe proximal femoral deformity and hypoplasia, some authors consider modular implants unsuitable and believe custommade implants provide a better option, especially when addressing excessive femoral neck anteversion, which frequently is seen in patients with skeletal dysplasia [1,8,23]. In addition, customized components maximize the fit and fill in the proximal femur at the time of implantation and thereby provide better stability for the femoral component [14,22].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, customized components maximize the fit and fill in the proximal femur at the time of implantation and thereby provide better stability for the femoral component [14,22]. Some authors have reported the use of standard THA implants in patients with short stature [8,19,25,29]. Although some studies are limited by low patient numbers and short followups, revision rates of 4% to 30%, intraoperative femoral fracture rates of 3% to 17% and nerve palsy rates of 2% to 13% have been reported with mean followups of 4.8 to 11.5 years [8,19,25,29].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors have reported the use of standard THA implants in patients with short stature [8,19,25,29]. Although some studies are limited by low patient numbers and short followups, revision rates of 4% to 30%, intraoperative femoral fracture rates of 3% to 17% and nerve palsy rates of 2% to 13% have been reported with mean followups of 4.8 to 11.5 years [8,19,25,29]. One study [16] reported 79 patients with OA secondary to developmental dysplasia of the hip who had custom cementless devices.…”

Section: Introductionmentioning

confidence: 99%

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Custom Cementless THA in Patients with Skeletal Dysplasia Results in Lower Apparent Revision Rates than Other Types of Femoral Fixation

Sewell

Hanna

Muirhead-Allwood

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Patients with skeletal dysplasia are prone to degenerative hip disease thus requiring THA at a younger age than the general population. This is a technically demanding procedure with high complication and revision rates. Achieving good femoral fixation can be challenging because of the abnormal features of the hip. Questions/purposes We therefore determined: (1) survivorship, (2) function, (3) radiographic findings, and (4) complications associated with a cementless custommade femoral component used in THAs for patients with skeletal dysplasia and compared these parameters with those from other types of femoral fixation. Patients and Methods Between 1992 and 2005, 40 THAs were performed in 25 patients with skeletal dysplasia using custom-made cementless femoral components. There were 15 men and 10 women with a mean age of 37.5 years (range, 18-61 years) and a mean height of 145 cm (range, 120-173 cm). Patients were followed clinically and radiographically for a minimum of 4.3 years (mean, 10.1 years; range, 4.3-18.2 years). ResultsThe survivorship rates for the femoral and acetabular components were 92% and 70%, respectively, at 220 months. Revision arthroplasty was performed in four of 40 hips (10%). In two, the acetabular component was revised for aseptic loosening, one had both components revised for aseptic loosening, and one had an isolated femoral component revision for deep infection. The mean Harris hip score improved from 41 (range, 27-57) preoperatively to 80 (range, 51-94) at final followup. There were two intraoperative proximal femoral fractures and one dislocation. Conclusions When compared with studies with equal followup, custom-made cementless components in THAs for patients with skeletal dysplasia apparently had lower revision and complication rates with comparable function and higher midterm survival.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Custom Cementless THA in Patients with Skeletal Dysplasia Results in Lower Apparent Revision Rates than Other Types of Femoral Fixation

Sewell

Hanna

Muirhead-Allwood

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Risk Assessment (Comorbidities)

Koyano

2024

Advances in Total Hip Arthroplasty

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Custom total hip arthroplasty in skeletal dysplasia

Osagie

Figgie

Bostrom

2011

International Orthopaedics (SICOT)

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Purpose Osteochondrodysplasias are characterised by aberrant cartilage and bone development; consequently, patients may be subject to premature hip degeneration. In this population hip arthroplasty outcomes are variable. This series reviews the use of custom femoral implants in total hip replacements for patients with severe skeletal dysplasia. Methods We reviewed 14 hips in nine patients with genetic dwarfism. Computed tomography (CT) scans of the pelvis and femurs were used to create custom titanium stems. Postoperative radiographs were reviewed for migration, osteolysis, fracture and restoration of leg length. Pre-and postoperative Harris hip scores (HHS) were compared, with a mean follow-up of 36.3 months. Mean age was 36.5 years (range 15-50 years) and mean height was 48 inches (range 42-55 inches). Three joints were classified as Crowe type I, two type II, three type III and six type IV. Results Three hips (21%) required revision: two for stem migration and one for acetabular osteolysis. Eleven hips (79%) were stable with signs of osseointegration. No fractures, nerve damage or dislocations occurred. Two stems required cement fixation, and no liners were constrained. Significant osteolysis was seen on three radiographs. All patients walked independently, and mean HHS improved from 45 (24-58) to 71 (47-89). All leg length discrepancies were restored to within 3 mm of equal. Conclusions This study reports good midterm outcomes in a variety of skeletal dysplasias, thus confirming the efficacy of custom femoral implants in the management of this patient group.

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Total Hip Arthroplasty in Patients with Dwarfism

Cited by 46 publications

References 18 publications

Custom Cementless THA in Patients with Skeletal Dysplasia Results in Lower Apparent Revision Rates than Other Types of Femoral Fixation

Custom Cementless THA in Patients with Skeletal Dysplasia Results in Lower Apparent Revision Rates than Other Types of Femoral Fixation

Risk Assessment (Comorbidities)

Custom total hip arthroplasty in skeletal dysplasia

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