scholarly journals The Influence of Acetabular Morphologic Variations on the Cup Position in Total Hip Arthroplasty for Crowe type III Dysplastic Hip

2021 ◽  
Author(s):  
Junmin Shen ◽  
Ti Zhang ◽  
Yu Dong ◽  
Yanchao Zhang ◽  
Yonggang Zhou ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Anatomical Reconstruction ◽  
Acetabular Roof ◽  
Center Of Rotation ◽  
Total Hip ◽  
Vertical Distance ◽  
Center Edge ◽  
Cup Position

Abstract Background: We aimed to (1) evaluate the acetabular morphologic variations of Crowe III hips; (2) study the influence of different morphologies on the cup position in total hip arthroplasty.Methods: From November 2008 to February 2019, we retrospectively evaluated 101 patients (110 hips) with Crowe III developmental dysplasia of the hip. We classified Crowe III hips into two subtypes, the IIIA when the acetabular roof was extensively deficient and the junction between the false and the true acetabulum was indistinct, and the IIIB when there is a significant crest between the false and the true acetabulum. Based on the radiographs, we measured the morphological characteristic of the acetabulum and the postoperative cup position.Results: The false acetabulum of IIIB hips had larger Tonnis angle and smaller center-edge angle than the IIIA hips. The width of true acetabular roof in the IIIB hips was thicker than the IIIA group. Fifty-one (100%) IIIA hips and 48 (81.4%) IIIB hips were reconstructed using high hip center while 11 (18.6%) IIIB hips were reconstructed anatomically. The mean vertical distance of center of rotation in the IIIA group was 33.5±4.5 mm while it was 31.2±6.3 mm in the IIIB group (p=0.040). The vertical distance of the hip center was positively correlated with the height of dislocation in the IIIA group (r=0.493, p<0.001). According to the four-zone system, in the IIIA group, 5 hips were located in the inferomedial zone, 23 hips in the superomedial zone, 22 hips in the superolateral zone and 1 hip in the inferolateral zone. In the IIIB group, the corresponding numbers were respectively 15, 17, 1 and 5. Compared with the IIIA group, there were more IIIB hips located in the inferomedial zone (p=0.008) and less in the superolateral zone (p=0.033).Conclusions: There are distinct morphologic subtypes based on the relationship between the false and the true acetabulum. More bone stock located in the superior wall of the true acetabulum can bring more possibilities for anatomical reconstruction, and lower the height of center of rotation when using high hip center.

scholarly journals Functional and radiographical results of asymmetrically reconstructed total hip arthroplasty in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other Crowe IV: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Junmin Shen ◽  
Jingyang Sun ◽  
Yinqiao Du ◽  
Bohan Zhang ◽  
Tiejian Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
The Other ◽  
Anatomical Reconstruction ◽  
Center Of Rotation ◽  
Total Hip ◽  
Anatomical Position ◽  
Significant Difference ◽  
The Mean

Abstract Background The study aimed to evaluate the functional and radiographical results of asymmetrically reconstructed total hip arthroplasty in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other hip Crowe IV. Materials and methods From April 2006 to April 2019, we evaluated 23 patients who had a reconstruction of one Crowe II–III hip with high hip center (HHC) and the other Crowe IV hip at the anatomical position (H group). The radiographic and clinical outcomes were compared with those of a control group of 19 patients with bilateral dysplasia who had one Crowe IV hip and the contralateral hip both reconstructed in the anatomical position (A group). Medical records and radiographs were reviewed, and a complete follow-up was conducted for all patients. Results The mean vertical center of rotation (V-COR) and horizontal center of rotation (H-COR) in the H group were 30.6 ± 5.8 mm and 30.0 ± 5.5 mm, respectively. In the A group, the corresponding values were 14.0 ± 4.3 mm and 23.0 ± 2.3 mm, respectively. A significant difference was found in terms of V-COR and H-COR between the two groups, and no significant difference was shown regarding the cup inclination, abductor lever arm (ALA), ALA ratio, and leg length discrepancy (LLD). Three patients of the H group and four patients of the A group exhibited LLD > 10 mm. All seven patients who had LLD > 10 mm underwent the shortening subtrochanteric osteotomy (SSTO) of the Crowe IV hip. Subgroup analysis based on the presence and absence of SSTO showed that the LLD of the SSTO group was greater than that of the non-SSTO group in both groups, but the difference was only statistically significant in the A group. At the last follow-up, the mean Harris Hip Scores significantly improved in the two groups, and there was no revision during the follow-up period. In the H group, four patients presented with a slight limp and three patients with a moderate limp, while it was six patients and one patient in the A group, respectively. Conclusions Asymmetrical reconstruction in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other Crowe IV is acceptable and comparable when compared with bilateral anatomical reconstruction. Level of evidence III, retrospective observational study. Trial registration Chinese Clinical Trail Registry. ChiCTR2000033848

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

Dislocation After Total Hip Arthroplasty Among Patients With Developmental Dysplasia of the Hip

2012 ◽  
Vol 27 (5) ◽  
pp. 764-769 ◽  
Author(s):  
Liao Wang ◽  
Robert T. Trousdale ◽  
Songtao Ai ◽  
Kai-Nan An ◽  
Kerong Dai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Total Hip ◽  
Dysplasia Of The Hip
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