scholarly journals Functional and Radiological Outcomes After Treatment with Custom-Made Acetabular Components in Patients with Paprosky type 3 Acetabular Defects: Short-Term Results

2020 ◽  
Author(s):  
Michael Stephan Gruber ◽  
Michael Jesenko ◽  
Julia Burghuber ◽  
Josef Hochreiter ◽  
Peter Ritschl ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Special Treatment ◽  
Level Of Evidence ◽  
Custom Made ◽  
Significant Difference ◽  
Oxford Hip Score ◽  
Acetabular Defects ◽  
Type 3 ◽  
Acetabular Components

Abstract BackgroundSevere acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects.MethodsSixteen patients were included in this trial, nine of whom completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics.ResultsThe mean follow-up time of the nine patients was 13.6 months (± 5.6 SD). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed no significant difference in offset measurements except for femoral offset (41.8 mm on the contralateral and 35.2 mm on the treated hip, p = 0.044).ConclusionsThe functional and radiological outcomes are promising. However, long-term outcomes still need to be examined.Level of Evidence: Therapeutic Level IV.

scholarly journals Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

2020 ◽  
Author(s):  
Michael Stephan Gruber ◽  
Michael Jesenko ◽  
Julia Burghuber ◽  
Josef Hochreiter ◽  
Peter Ritschl ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Special Treatment ◽  
Center Of Rotation ◽  
Custom Made ◽  
Significant Difference ◽  
Oxford Hip Score ◽  
Acetabular Defects ◽  
Type 3 ◽  
Acetabular Components

Abstract Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects.Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics.Results The mean follow-up time of the nine patients was 12.2 months (range: 10 - 18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset.Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined.Level of Evidence: Therapeutic Level IV.

scholarly journals Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael S. Gruber ◽  
Michael Jesenko ◽  
Julia Burghuber ◽  
Josef Hochreiter ◽  
Peter Ritschl ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Special Treatment ◽  
Center Of Rotation ◽  
Custom Made ◽  
Significant Difference ◽  
Oxford Hip Score ◽  
Acetabular Defects ◽  
Type 3 ◽  
Acetabular Components

Abstract Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects. Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics. Results The mean follow-up time of the nine patients was 12.2 months (range: 10–18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset. Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined. Level of evidence Therapeutic Level IV.

scholarly journals Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Loris Perticarini ◽  
Stefano Marco Paolo Rossi ◽  
Marta Medetti ◽  
Francesco Benazzo
Keyword(s):  
Revision Surgery ◽  
Case Series ◽  
Bone Defects ◽  
Harris Hip Score ◽  
Type Ii ◽  
Level Of Evidence ◽  
Kaplan Meier ◽  
Prospective Case Series ◽  
Acetabular Components

Abstract Background This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. Methods Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29–90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. Results Average follow-up was 91 (range 24–146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25–70; SD 9) preoperatively to 84.4 (range 46–99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan–Meier survivorship was assessed to be 88.54% (95% CI 80.18–93.52%) at 71 months, with failure of the cup for any reason as the endpoint. Conclusion Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. Level of evidence Level IV prospective case series

scholarly journals Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

2019 ◽  
Author(s):  
Hao Tang ◽  
Yixin Zhou ◽  
Zhuyi Ma ◽  
Yong Huang ◽  
Shengjie Guo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Metal ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Fixation Group ◽  
Acetabular Defects ◽  
Type 3

Abstract Background: We proposed a new concept of “iliac extended fixation” in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects. Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected. Results: At an average follow-up of 40 months (range 25 – 64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group. Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

scholarly journals Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

2019 ◽  
Author(s):  
Hao Tang ◽  
Yixin Zhou ◽  
Zhuyi Ma ◽  
Yong Huang ◽  
Shengjie Guo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Metal ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Fixation Group ◽  
Acetabular Defects ◽  
Type 3

Abstract Background: We proposed a new concept of “iliac extended fixation” in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects. Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected. Results: At an average follow-up of 40 months (range 25 – 64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group. Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

scholarly journals Multicup reconstruction technique for the management of severe protrusio acetabular defects

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Baochao Ji ◽  
Guoqing Li ◽  
Xiaogang Zhang ◽  
Yang Wang ◽  
Wenbo Mu ◽  
...  
Keyword(s):  
Survival Rate ◽  
Bone Ingrowth ◽  
Harris Hip Score ◽  
Reconstruction Technique ◽  
High Survival ◽  
Level Of Evidence ◽  
Therapeutic Study ◽  
Acetabular Defects ◽  
Acetabular Components ◽  
Acetabular Loosening

Abstract Background In revision hip arthroplasty, managing the large protrusio acetabular defects remains a challenge. The report described a novel technique which employs a trabecular metal revision shell as a super-augment to buttress the superior medial structure. Methods Between January 2015 and December 2018, the multicup reconstruction was performed in 21 patients with severe protrusio acetabular defects. The revision shell, plus two similar porous acetabular components was implanted into the initial shell to create a “multicup” construct. The functional outcomes were evaluated in terms of the Harris Hip Score. Acetabular loosening, restoration of hip center of rotation, and bone ingrowth etc., were radiographically assessed. The survival rate of the implants was also evaluated. Results A followup lasting a mean time of 31 months (range, 18–57 months) revealed that the average Harris Hip Score improved from preoperative 37.0 ± 7.1 to postoperative 76.4 ± 9.0. There were no revisions due to acetabular loosening. The horizontal offset increased by an average of 14 mm, and the vertical offset decreased by an average of 18 mm. Eighteen of the 21 patients (86 %) met at least 3 of 5 criteria associated with bone ingrowth. The survivorship free from re-revision for acetabular loosening after 2 years was 100 %. Conclusions The multicup reconstruction technique was a simplified re-revision procedure for managing the severe protrusio acetabular defects and could achieve a high survival rate. Level of evidence Therapeutic study, Level IVa.

Arthroscopic Repair of the Hip Abductor Musculotendinous Unit: The Effect of Microfracture on Clinical Outcomes

2021 ◽  
pp. 036354652199967
Author(s):  
Baris Kocaoglu ◽  
Ahmet Emre Paksoy ◽  
Simone Cerciello ◽  
Matthieu Ollivier ◽  
Romain Seil ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Surgical Repair ◽  
Gluteus Medius ◽  
Arthroscopic Repair ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Outcome Score ◽  
Significant Difference ◽  
Hip Abductor ◽  
Tendon Tears

Background: Endoscopic surgical repair has become a common procedure for treating patients with hip abductor tendon tears. Considering that retear rates are high after the repair of gluteus medius and minimus tendons, exploring alternative strategies to enhance structural healing is important. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of adding microfracture to single-row repair (SR) on outcomes after the surgical repair of gluteus medius and minimus tendons and compare with SR and double-row repair (DR) without microfracture. We hypothesized that microfracture of the trochanteric footprint with SR would lead to superior clinical outcomes and lower clinically evident retear rates compared with SR and DR without the addition of microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 50 patients who underwent primary arthroscopic repair of hip gluteus medius and minimus tendon tears were investigated. Patients were divided into 3 groups: DR, 16 patients; SR, 14 patients; and SR with microfracture (SRM), 20 patients. Patients were evaluated with a visual analog scale (VAS) for pain as well as the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) both preoperatively and at a minimum 2-year follow-up (mean, 30 months). Results: Among the SR, SRM, and DR groups, the greatest decrease in VAS scores and increase in mHHS, HOS-ADL, and HOS-SS scores were seen in the SRM group, and all the differences were significant ( P < .001 to P = .006). The abductor tendon retear rates were 31.3%, 35.7%, and 15.0% in the DR, SR, and SRM groups, respectively. Retear rates were lower in the SRM group compared with the SR and DR groups ( P = .042); however, there was no significant difference between the SR and DR groups ( P = .32) in terms of retear rates. Conclusion: Endoscopic SR with microfracture was a safe, practical, and effective technique and had the potential advantage of enhancing biological healing at the footprint. The addition of microfracturing the trochanteric footprint significantly lowered the retear rate and provided better functional outcomes than SR and DR without microfracture.

scholarly journals Traditional versus mirror three-dimensional printing technology for isolated acetabular fractures: a retrospective study with a median follow-up of 25 months

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110285
Author(s):  
Kai Xiao ◽  
Bo Xu ◽  
Lin Ding ◽  
Weiguang Yu ◽  
Lei Bao ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Operation Time ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Printing Technology ◽  
Three Dimensional Printing ◽  
3D Printing Technology ◽  
Significant Difference

Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.

Comparing Midterm Outcomes of High-Level Athletes Versus Nonathletes Undergoing Primary Hip Arthroscopy: A Propensity-Matched Comparison With Minimum 5-Year Follow-up

2021 ◽  
pp. 036354652110417
Author(s):  
Andrew E. Jimenez ◽  
Peter F. Monahan ◽  
David R. Maldonado ◽  
Benjamin R. Saks ◽  
Hari K. Ankem ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Statistical Significance ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Control Group ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
High Level

Background: High-level athletes (HLAs) have been shown to have better short-term outcomes than nonathletes (NAs) after hip arthroscopy. Purpose: (1) To report midterm outcomes of HLAs after primary hip arthroscopy and (2) to compare their results with a propensity-matched cohort of NA patients. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed between February 2008 and November 2015 for HLAs (professional, college, or high school) who underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS). HLAs were included if they had preoperative, minimum 2-year, and minimum 5-year follow-up data for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sports-Specific Subscale (HOS-SSS). Radiographic and intraoperative findings, surgical procedures, patient-reported outcomes (PROs), patient acceptable symptomatic state (PASS), minimal clinically important difference (MCID), and return to sport were reported. The HLA study group was propensity-matched to a control group of NA patients for comparison. Results: A total 65 HLA patients (67 hips) were included in the final analysis with mean follow-up time of 74.6 ± 16.7 months. HLAs showed significant improvement in all PROs recorded, achieved high rates of MCID and PASS for mHHS (74.6% and 79.4%, respectively) and HOS-SSS (67.7% and 66.1%, respectively), and returned to sport at high rates (80.4%). When compared with the propensity-matched NA control group, HLAs reported higher baseline but comparable postoperative scores for the mHHS and NAHS. HLA patients achieved MCID and PASS for mHHS at similar rates as NA patients, but the HLA patients achieved PASS for HOS-SSS at higher rates that trended toward statistical significance (66.1% vs 48.4%; P = .07). NA patients underwent revision arthroscopic surgery at similar rates as HLA patients (14.9% vs 9.0%, respectively; P = .424). Conclusion: Primary hip arthroscopy results in favorable midterm outcomes in HLAs. When compared with a propensity-matched NA control group, HLAs demonstrated a tendency toward higher rates of achieving PASS for HOS-SSS but similar arthroscopic revision rates at minimum 5-year follow-up.

Sign in / Sign up

Export Citation Format

Share Document