scholarly journals How to restore rotation center in total hip arthroplasty for developmental dysplasia of the hip by recognizing the pathomorphology of acetabulum and Harris fossa?

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Heng Zhang ◽  
Jiansheng Zhou ◽  
Jianzhong Guan ◽  
Hai Ding ◽  
Zhiyan Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Horizontal Distance ◽  
Total Hip ◽  
Rotation Center ◽  
Pelvic Radiographs ◽  
End Stage ◽  
Hip Rotation ◽  
Dysplasia Of The Hip

Abstract Purpose To restore rotation center exactly in total hip arthroplasty (THA) is technically challenging for patients with end-stage osteoarthritis due to developmental dysplasia of the hip (DDH). The technical difficulty is attributable to the complex acetabular changes. In this study, we investigated the pathomorphology of acetabulum and Harris fossa of Crowe types I to IV and discussed the method of restoring rotation center of the hip. Methods This study retrospectively reviewed 56 patients (59 hips) who underwent cementless THA due to end-stage osteoarthritis of DDH. The pathomorphology of acetabulum and Harris fossa was observed during operations. Using the preoperative and postoperative pelvic radiographs, the vertical and the horizontal distances of hip rotation center were measured in order to evaluate the effects of restoring rotation center of the hip. Results Adult DDH acetabulum could be classified into four basic pathological types which include the shallow cup shape, the dish shape, the shell shape, and the triangular shape. Adult DDH Harris fossa could be classified into four pathological types, including the crack shape, the closed shape, the triangle shape, and the shallow shape, in accordance with the osteophyte coverage. The vertical and horizontal distances of hip rotation center on the pelvic radiographs before and after operations were as follows: the preoperative vertical distance of hip rotation center was (39.96 ± 5.65) mm, and the postoperative one was (13.83 ± 2.66) mm; the preoperative horizontal distance of hip rotation center was (42.15 ± 6.42) mm, and the postoperative one was (28.12 ± 4.56) mm. Conclusions The acetabulum and Harris fossa can display different pathological types on account of different degrees of dislocation and osteophyte hyperplasia in the end-stage osteoarthritis of adult DDH. The hip rotation center can be accurately restored by locating the acetabular center with Harris fossa and acetabular notch as the marks.

scholarly journals 3D printing navigation template used in total hip arthroplasty for developmental dysplasia of the hip

2019 ◽  
Author(s):  
liang yan ◽  
Peng Wang ◽  
Haibing Zhou
Keyword(s):  
3D Printing ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Ischial Tuberosity ◽  
Developmental Dysplasia ◽  
Abduction Angle ◽  
Total Hip ◽  
Rotation Center ◽  
Dysplasia Of The Hip ◽  
Navigation Template

Abstract Background: It is difficult to locate the real acetabulum in the total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH), The goal of this study was to explore the application of 3D printing navigation template used in total hip arthroplasty (THA) for developmental dysplasia of the hip. Methods: Between February 2017 and May 2018, THAs were performed in 25 patients with DDH, all patients (12 cases undergoing THA with 3D printing navigation template, 13 cases undergoing traditional THA) were followed-up for an average of 14.6 months. Surgical information and outcomes treated with different approaches were compared. Results: The 3D printing group provided shorter operation time, lower intra- and post-operative hemorrhage and higher post-operative Harris scores. postoperative infection and prosthetic loosening were 0 in two groups. There were no significant differences in anteversion angle, abduction angle and the distance from rotation center to the ischial tuberosity connection between ipsilateral and contralateral sides in 3D printing group. The abduction angle and the distance from rotation center to the ischial tuberosity connection were significantly different between the two sides in the traditional group. Conclusion: The finding suggests that 3D printing navigation template used in total hip arthroplasty is an individualized, accurate technology. Keywords: 3D printing technology, total hip arthroplasty, developmental dysplasia of the hip, navigation template

scholarly journals Medium-term outcomes of total hip arthroplasty in juvenile patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Francesco Luceri ◽  
Ilaria Morelli ◽  
Carlo Maria Sinicato ◽  
Alberto Della Grazia ◽  
Fabio Verdoni ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Slipped Capital Femoral Epiphysis ◽  
Hip Osteoarthritis ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Total Hip ◽  
Stage Juvenile ◽  
End Stage ◽  
Dysplasia Of The Hip

Abstract Background Juvenile hip osteoarthritis is often the end result of congenital conditions or acquired hip ailments occurred during the paediatric age. This study evaluated the middle term results of total hip arthroplasty for end-stage juvenile hip osteoarthritis. Materials and methods This is a retrospective analysis of prospectively collected data on a cohort of 10 consecutive patients (12 hips), aged between 14 and 20 at operation, who underwent cementless total hip arthroplasty for end-stage juvenile secondary hip osteoarthritis in two orthopaedic tertiary referral centres between 2009 and 2018. Results Juvenile hip osteoarthritis occurred as a consequence of developmental dysplasia of the hip, Legg-Calvé-Perthes disease, femoral head necrosis or slipped capital femoral epiphysis. All patients showed a significant improvement in Harris Hip Score (p < 0.01) at 3.3 years average follow-up (range 0.7–10.1 years). Conclusion The management of juvenile hip osteoarthritis following developmental dysplasia of the hip, Legg-Calvé-Perthes disease, femoral head necrosis or slipped capital femoral epiphysis is still challenging. Careful preoperative planning is essential to achieve good outcomes and improve the Harris Hip Score in these young patients. Total hip arthroplasty is a suitable option for end-stage secondary juvenile hip osteoarthritis, when proximal femoral osteotomies and conservative treatments fail to improve patients’ symptoms and quality of life. Level of evidence IV

Challenges in Total Hip Arthroplasty in the Setting of Developmental Dysplasia of the Hip

2017 ◽  
Vol 32 (9) ◽  
pp. S38-S44 ◽  
Author(s):  
Eric M. Greber ◽  
Christopher E. Pelt ◽  
Jeremy M. Gililland ◽  
Mike B. Anderson ◽  
Jill A. Erickson ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Total Hip ◽  
Dysplasia Of The Hip
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