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.	吴立东,熊炎,严世贵,等.非骨水泥臼杯加自体股骨头植骨全髋关节置换术治疗髋臼发育不良伴骨关节炎.中华外科杂志, 2004, 42(16):1006-1009.
5.	孙俊英,郝跃峰,杨沛彦,等.采用小臼杯置换与髋臼加深行全髋关节置换治疗CroweⅣ型髋脱位.中国骨伤, 2009, 22(6):407-409.
6.	廖红兴,刘展亮,李晓彬,等.全髋关节置换术治疗CroweⅣ型髋关节发育不良的疗效分析.实用骨科杂志, 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.	吕厚山.人工关节外科学.北京:科学出版社, 1988:121-127.
14.	宋展昭,徐朋,张伟,等.髋臼加深全髋置换治疗成人先天髋臼发育不良.中国矫形外科杂志, 2001, 8(9):844-846.
15.	朱振安,戴尅戎,王友,等.全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节脱位的临床研究.中华外科杂志, 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,管国华,李雄峰,等.全髋关节置换术治疗Crowe IV型髋关节发育不良患者及围手术期并发症分析.中国骨伤, 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.	孙俊英,郝跃峰,杨沛彦,等.羟基磷灰石涂层股骨柄假体全髋关节置换术的中期疗效.中华骨科杂志, 2009, 29(10):897-900.
20.	孙俊英,郝跃峰,杨沛彦,等.股骨转子下叠加缩短截骨在Crowe IV型成人髋脱位全髋置换术的应用.中华骨科杂志, 2008, 28(1):9-13.
21.	游镇君,孙俊英,查国春,等.生物型人工全髋关节置换术治疗股骨近段畸形合并终极髋关节疾病.中国修复重建外科杂志, 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. 吴立东,熊炎,严世贵,等.非骨水泥臼杯加自体股骨头植骨全髋关节置换术治疗髋臼发育不良伴骨关节炎.中华外科杂志, 2004, 42(16):1006-1009.
5. 孙俊英,郝跃峰,杨沛彦,等.采用小臼杯置换与髋臼加深行全髋关节置换治疗CroweⅣ型髋脱位.中国骨伤, 2009, 22(6):407-409.
6. 廖红兴,刘展亮,李晓彬,等.全髋关节置换术治疗CroweⅣ型髋关节发育不良的疗效分析.实用骨科杂志, 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. 吕厚山.人工关节外科学.北京:科学出版社, 1988:121-127.
14. 宋展昭,徐朋,张伟,等.髋臼加深全髋置换治疗成人先天髋臼发育不良.中国矫形外科杂志, 2001, 8(9):844-846.
15. 朱振安,戴尅戎,王友,等.全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节脱位的临床研究.中华外科杂志, 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,管国华,李雄峰,等.全髋关节置换术治疗Crowe IV型髋关节发育不良患者及围手术期并发症分析.中国骨伤, 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. 孙俊英,郝跃峰,杨沛彦,等.羟基磷灰石涂层股骨柄假体全髋关节置换术的中期疗效.中华骨科杂志, 2009, 29(10):897-900.
20. 孙俊英,郝跃峰,杨沛彦,等.股骨转子下叠加缩短截骨在Crowe IV型成人髋脱位全髋置换术的应用.中华骨科杂志, 2008, 28(1):9-13.
21. 游镇君,孙俊英,查国春,等.生物型人工全髋关节置换术治疗股骨近段畸形合并终极髋关节疾病.中国修复重建外科杂志, 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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