Acetabular Morphology in Patients with Developmental Dysplasia of the Hip with High Dislocation
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The current study aimed to investigate the morphology of the true acetabulum in developmental dysplasia of the hip (DDH) with high dislocation. A secondary was to evaluate the acetabular cup placement in patients with high dislocation who were treated with total hip arthroplasty (THA). Materials and Methods: Using a retrospective design, 23 hips with DDH with high dislocation in patients who were treated with THA were included in this study. We measured the depth, width and thickness of the anterior and posterior walls of the original acetabulum using preoperative computed tomography images and investigated the cup size applied in these cases. Results: The mean depth and width of the acetabulum was 18.4 and 16.2 mm proximal end, 18.4 and 24.3 mm in the middle, and 15.8 and 27.6 mm at the distal part. Mean thickness of the anterior and posterior walls was 10.9 and 23.9 mm at the proximal end, 10.3 and 22.2 mm in the middle, and 10.9 and 22.7 mm at the distal part. A 42-mm cup was using in one hip, a 46-mm cup in three hips, a 48-mm cup in 13 hips, and a 50-mm cup in six hips. Conclusion: In patients with Crowe IV DDH, the morphology of the acetabulum comprises a triangle that broadens from proximal to distal points, with a relatively thick posterior wall. Reaming the acetabulum posteriorly and inferiorly may enable the placement of a relatively larger cup to achieve stable fixation.
Abstract
Purpose: The current study aimed to investigate the morphology of the true acetabulum in developmental dysplasia of the hip (DDH) with high dislocation. A secondary was to evaluate the acetabular cup placement in patients with high dislocation who were treated with total hip arthroplasty (THA). Materials and Methods: Using a retrospective design, 23 hips with DDH with high dislocation in patients who were treated with THA were included in this study. We measured the depth, width and thickness of the anterior and posterior walls of the original acetabulum using preoperative computed tomography images and investigated the cup size applied in these cases. Results: The mean depth and width of the acetabulum was 18.4 and 16.2 mm proximal end, 18.4 and 24.3 mm in the middle, and 15.8 and 27.6 mm at the distal part. Mean thickness of the anterior and posterior walls was 10.9 and 23.9 mm at the proximal end, 10.3 and 22.2 mm in the middle, and 10.9 and 22.7 mm at the distal part. A 42-mm cup was using in one hip, a 46-mm cup in three hips, a 48-mm cup in 13 hips, and a 50-mm cup in six hips. Conclusion: In patients with Crowe IV DDH, the morphology of the acetabulum comprises a triangle that broadens from proximal to distal points, with a relatively thick posterior wall. Reaming the acetabulum posteriorly and inferiorly may enable the placement of a relatively larger cup to achieve stable fixation.
참고문헌 (21)
- Dunn HK, "Total hip reconstruction in chronically dislocated hips", J Bone Joint Surg Am, 58, pp.838~845 (1976)
- Hartofilakidis G, "Low friction arthroplasty for old untreated congenital dislocation of the hip", J Bone Joint Surg Br, 70, pp.182~186 (1988)
- Paavilainen T, "Cementless total replacement for severely dysplastic or dislocated hips", J Bone Joint Surg Br, 72, pp.205~211 (1990)
- Jameson SS, "Lower rates of dislocation with increased femoral head size after primary total hip replacement : a five-year analysis of NHS patients in England", J Bone Joint Surg Br, 93, pp.876~880 (2011)
- Livermore J, "Effect of femoral head size on wear of the polyethylene acetabular component", J Bone Joint Surg Am, 72, pp.518~528 (1990)
- Xu J, "Posterosuperior placement of a standard-sized cup at the true acetabulum in acetabular reconstruction of developmental dysplasia of the hip with high dislocation", J Arthroplasty, 31, pp.1233~1239 (2016)
- Nagoya S, "Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip", J Bone Joint Surg Br, 91, pp.1142~1147 (2009)
- Suzuki D, "Three-dimensional orientation of the acetabulum", Clin Anat, 30, pp.753~760 (2017)
- Augustine AS, "Variations in pelvic dimensions : an anatomical and computed tomography study", Clin Anat, 31, pp.981~987 (2018)
- Dunn PM, "The anatomy and pathology of congenital dislocation of the hip", Clin Orthop Relat Res, (119), pp.23~27 (1976)
- Sugano N, "Polyethylene sockets and alumina ceramic heads in cemented total hip arthroplasty. A ten-year study", J Bone Joint Surg Br, 77, pp.548~556 (1995)
- Takao M, "The results of a press-fit-only technique for acetabular fixation in hip dysplasia", J Arthroplasty, 26, pp.562~568 (2011)
- Rogers BA, "Total hip arthroplasty for adult hip dysplasia", J Bone Joint Surg Am, 94, pp.1809~1821 (2012)
- Holzapfel BM, "Total hip replacement in developmental dysplasia using an oval-shaped cementless press-fit cup", Int Orthop, 36, pp.1355~1361 (2012)
- Crowe JF, "Total hip replacement in congenital dislocation and dysplasia of the hip", J Bone Joint Surg Am, 61, pp.15~23 (1979)
- Hayashi S, "Multiple revision surgeries and acetabular bone defect size may predict daily activity after revision total hip arthroplasty", J Arthroplasty, 32, pp.1606~1611 (2017)
- Hartofilakidis G, "Treatment of high dislocation of the hip in adults with total hip arthroplasty. Operative technique and long-term clinical results", J Bone Joint Surg Am, 80, pp.510~517 (1998)
- Hartofilakidis G, "Total hip arthroplasty for congenital hip disease", J Bone Joint Surg Am, 86, pp.242~250 (2004)
- Yang Y, "Morphological analysis of true acetabulum in hip dysplasia(Crowe Classes I-IV)Via 3-D implantation simulation", J Bone Joint Surg Am, 99, pp.e92~ (2017)
- Pauwels F., "Biomechanics of the normal and diseased hip:theoretical foundation, technique and results of treatment:an atlas" (1976), Springer-Verlag
- Bombelli R., "Osteoarthritis of the hip: classification and pathogenesis the role of osteotomy as a consequent therapy", pp.89~108 (1983), Springer-Verlag