APPLICATION AND EFFECTIVENESS OF BIOLOGICAL TYPE ACETABULAR CUP IN ADULT Crowe TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XUNing ,  SUNJunying , ZHAOXijiang , WANGTao

Department of Orthopedics, the First Hospital Affiliated to Soochow University, Suzhou Jiangsu, 215006, P. R. China;

Corresponding?author：

SUNJunying, Email: sun_junying@hotmail.com

Keywords：

Developmental dysplasia of the hip; Biological small cup; Total hip arthroplasty; Adult

DOI：

10.7507/1002-1892.20160008

Video：

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Objective To investigate the application and effectiveness of the biological type acetabular cup (diameter ＜44 mm) in adult Crowe type IV developmental dysplasia of the hip (DDH). Methods Between April 2001 and August 2013, biological type acetabular cup was used in total hip arthroplasty for the treatment of Crowe type IV DDH in 16 cases (20 hips). There were 3 males and 13 females, aged 31-69 years (mean, 49 years). Unilateral hip was involved in 12 cases, and bilateral hips in 4 cases. The patients showed pain of the hip joint and inequality of lower limb (shortening of affected limb 1.8-6.0 cm in length, 3.5 cm on average). Acetabular deformity, the relationship and the severity of femoral head dislocation were comfirmed on the X-ray films. The preoperative Harris score was 34.0±6.9. Results All patients achieved healing of incision by first intention, with no complication of infection or neurovascular injury. Sixteen cases were followed up 4-12 years (mean, 7.5 years). At 2 weeks after operation, dislocation occurred in 2 cases, and were fixed with plaster for 3 weeks after reduction of the hip. Postoperative X-ray films showed complete reduction of femoral head; the average acetabular coverage of the cup of the weight-bearing area was 98.5% (range, 98.2%-99.1%). The cup from the Ranawat triangle was 4.6-7.0 mm (mean, 5.8 mm) in medial shifting, and was 4.5-7.9 mm (mean, 6.2 mm) in elevation, it located at cup lateral surface area inside the iliopectineal line and the Kohler line (＜40%); the cup abduction angle was (45±5)°, and the anteversion angle was (10±5)°. The other patients had no prosthesis loosening except 1 patient having extensive acetabular prosthesis loosening because of acetabular osteolysis at 12 years after operation. The hip Harris score was significantly improved to 85.0±7.5 at 1 year after operation (t=14.34, P=0.01). Conclusion The acetabular grinding process to retain enough bone combined with a small cup of biological prosthesis treating adult Crowe type IV DDH has the advantages of satisfactory coverage and initial acetabular fixation, so good early and mid-term effectiveness can be obtained.

Citation： XUNing, SUNJunying, ZHAOXijiang, WANGTao. APPLICATION AND EFFECTIVENESS OF BIOLOGICAL TYPE ACETABULAR CUP IN ADULT Crowe TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(1): 35-38. doi: 10.7507/1002-1892.20160008 Copy

1.	Karachalios T, Hartofilakidis G. Congenital hip disease in adults. Terminology, classification, pre-operative planning and management. J Bone Joint Surg (Br), 2010, 92(7):914-921.
2.	Umer M, Nawaz H, Kasi PM, et al. Outcome of triple procedure in older children with developmental dysplasia of hip (DDH). J Pak Med Assoc, 2007, 57(12):591-595.
3.	Wedge JH, Kelley SP. Strategies to improve outcomes from operative childhood management of DDH. Orthop Clin North Am, 2012, 43(3):291-299.
4.	吳立東,熊炎,嚴世貴,等.非骨水泥臼杯加自體股骨頭植骨全髖關節置換術治療髖臼發育不良伴骨關節炎.中華外科雜志, 2004, 42(16):1006-1009.
5.	孫俊英,郝躍峰,楊沛彥,等.采用小臼杯置換與髖臼加深行全髖關節置換治療CroweⅣ型髖脫位.中國骨傷, 2009, 22(6):407-409.
6.	廖紅興,劉展亮,李曉彬,等.全髖關節置換術治療CroweⅣ型髖關節發育不良的療效分析.實用骨科雜志, 2014, 20(3):217-219.
7.	Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1):15-23.
8.	Latimer HA, Lachiewicz PF. Porous-coated acetabular components with screw fixation. Five to ten-year results. J Bone Joint Surg (Am), 1996, 78(7):975-981.
9.	Kawamura H, Dunbar MJ, Murray P, et al. The porous coated anatomic total hip replacement a ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg (Am), 2001, 83-A(9):1333-1338.
10.	Morsi E, Garhuz D, Stockley I, et al. Totalhip replacement in dysplastic hips using femoral head shelf autografts. Clin Orthop Relat Res, 1996, (324):164-168.
11.	Shinar AA, Harris WH. Bulk structural autogenous grafls and allografis forreconstruction of the acetabulum in totalhip arthroplasty:sixteen-year averagefollow-up. J Bone Joint Surg (Am), 1997, 79(2):159-168.
12.	Mulroy RD, Harris WH. Failure of acetabular autogenous gratis in total hip arthroplasty. Increasing incidence:a follow-up note. J Bone Joint Surg (Am), 1990, 72(10):1536-1540.
13.	呂厚山.人工關節外科學.北京:科學出版社, 1988:121-127.
14.	宋展昭,徐朋,張偉,等.髖臼加深全髖置換治療成人先天髖臼發育不良.中國矯形外科雜志, 2001, 8(9):844-846.
15.	朱振安,戴尅戎,王友,等.全髖關節置換術治療成人Crowe Ⅳ型先天性髖關節脫位的臨床研究.中華外科雜志, 2006, 44(20):1403-1406.
16.	Hartofilakidis G, Stsmos K, Kerachalios T, et al. Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined witll total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(5):683-692.
17.	李建有,管國華,李雄峰,等.全髖關節置換術治療Crowe IV型髖關節發育不良患者及圍手術期并發癥分析.中國骨傷, 2012, 25(1):74-77.
18.	Sochart DH, Porter ML. The long-term results of Charnley low-friction arthroplasty in young patients who have congenital dislocation, degenerative asteoarthrosis or rheumatoid arthritis. J Bone Joint Surg (Am), 1997, 79(11):1599-1617.
19.	孫俊英,郝躍峰,楊沛彥,等.羥基磷灰石涂層股骨柄假體全髖關節置換術的中期療效.中華骨科雜志, 2009, 29(10):897-900.
20.	孫俊英,郝躍峰,楊沛彥,等.股骨轉子下疊加縮短截骨在Crowe IV型成人髖脫位全髖置換術的應用.中華骨科雜志, 2008, 28(1):9-13.
21.	游鎮君,孫俊英,查國春,等.生物型人工全髖關節置換術治療股骨近段畸形合并終極髖關節疾病.中國修復重建外科雜志, 2015, 29(3):265-269.

1. Karachalios T, Hartofilakidis G. Congenital hip disease in adults. Terminology, classification, pre-operative planning and management. J Bone Joint Surg (Br), 2010, 92(7):914-921.
2. Umer M, Nawaz H, Kasi PM, et al. Outcome of triple procedure in older children with developmental dysplasia of hip (DDH). J Pak Med Assoc, 2007, 57(12):591-595.
3. Wedge JH, Kelley SP. Strategies to improve outcomes from operative childhood management of DDH. Orthop Clin North Am, 2012, 43(3):291-299.
4. 吳立東,熊炎,嚴世貴,等.非骨水泥臼杯加自體股骨頭植骨全髖關節置換術治療髖臼發育不良伴骨關節炎.中華外科雜志, 2004, 42(16):1006-1009.
5. 孫俊英,郝躍峰,楊沛彥,等.采用小臼杯置換與髖臼加深行全髖關節置換治療CroweⅣ型髖脫位.中國骨傷, 2009, 22(6):407-409.
6. 廖紅興,劉展亮,李曉彬,等.全髖關節置換術治療CroweⅣ型髖關節發育不良的療效分析.實用骨科雜志, 2014, 20(3):217-219.
7. Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1):15-23.
8. Latimer HA, Lachiewicz PF. Porous-coated acetabular components with screw fixation. Five to ten-year results. J Bone Joint Surg (Am), 1996, 78(7):975-981.
9. Kawamura H, Dunbar MJ, Murray P, et al. The porous coated anatomic total hip replacement a ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg (Am), 2001, 83-A(9):1333-1338.
10. Morsi E, Garhuz D, Stockley I, et al. Totalhip replacement in dysplastic hips using femoral head shelf autografts. Clin Orthop Relat Res, 1996, (324):164-168.
11. Shinar AA, Harris WH. Bulk structural autogenous grafls and allografis forreconstruction of the acetabulum in totalhip arthroplasty:sixteen-year averagefollow-up. J Bone Joint Surg (Am), 1997, 79(2):159-168.
12. Mulroy RD, Harris WH. Failure of acetabular autogenous gratis in total hip arthroplasty. Increasing incidence:a follow-up note. J Bone Joint Surg (Am), 1990, 72(10):1536-1540.
13. 呂厚山.人工關節外科學.北京:科學出版社, 1988:121-127.
14. 宋展昭,徐朋,張偉,等.髖臼加深全髖置換治療成人先天髖臼發育不良.中國矯形外科雜志, 2001, 8(9):844-846.
15. 朱振安,戴尅戎,王友,等.全髖關節置換術治療成人Crowe Ⅳ型先天性髖關節脫位的臨床研究.中華外科雜志, 2006, 44(20):1403-1406.
16. Hartofilakidis G, Stsmos K, Kerachalios T, et al. Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined witll total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(5):683-692.
17. 李建有,管國華,李雄峰,等.全髖關節置換術治療Crowe IV型髖關節發育不良患者及圍手術期并發癥分析.中國骨傷, 2012, 25(1):74-77.
18. Sochart DH, Porter ML. The long-term results of Charnley low-friction arthroplasty in young patients who have congenital dislocation, degenerative asteoarthrosis or rheumatoid arthritis. J Bone Joint Surg (Am), 1997, 79(11):1599-1617.
19. 孫俊英,郝躍峰,楊沛彥,等.羥基磷灰石涂層股骨柄假體全髖關節置換術的中期療效.中華骨科雜志, 2009, 29(10):897-900.
20. 孫俊英,郝躍峰,楊沛彥,等.股骨轉子下疊加縮短截骨在Crowe IV型成人髖脫位全髖置換術的應用.中華骨科雜志, 2008, 28(1):9-13.
21. 游鎮君,孫俊英,查國春,等.生物型人工全髖關節置換術治療股骨近段畸形合并終極髖關節疾病.中國修復重建外科雜志, 2015, 29(3):265-269.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION AND EFFECTIVENESS OF BIOLOGICAL TYPE ACETABULAR CUP IN ADULT Crowe TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP

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