EFFECTIVENESS OF ANATOMIC FEMORAL COMPONENT PROSTHESIS FOR SEVERE DEVELOPMENTAL DYSPLASIA OF THE HIP IN TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ANXiao ,  DONGJiyuan , GONGKe , ZHANGQi , LIXiang , SONGWei

Department of Orthopedics, Chinese PLA General Hospital, Beijing, 100853, P. R. China;

Corresponding?author：

DONGJiyuan, Email: dongjiyuan81301@163.com

Keywords：

Developmental dysplasia of the hip; Total hip arthroplasty; Anatomic femoral component prosthesis

DOI：

10.7507/1002-1892.20150093

Video：

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Objective To evaluate the effectiveness of anatomic femoral component prosthesis for severe development dysplasia of the hip (DDH) in total hip arthroplasty (THA). Methods Between September 2009 and September 2013, 48 patients (51 hips) with severe DDH underwent THA with cementless anatomic femoral component prosthesis. There were 5 males (5 hips) and 43 females (46 hips) with an average age of 51 years (range, 28-67 years). The left hip was involved in 25 cases, the right hip in 20 cases, and bilateral hips in 3 cases. There were 39 cases (44 hips) of Crowe type Ⅲ and 9 cases (7 hips) of Crowe type ⅠV. The visual analogue scale (VAS) score was 5.72±1.84, and Harris score was 41.66±4.87 at preoperation. All patients had leg discrepancy with a length difference of (4.31±0.84) cm. Results The duration of surgery was 59-110 minutes (mean, 78.6 minutes), and the hospitalization days were 6-20 days (mean, 12.3 days). All patients obtained primary healing of incision without wound related complications of swelling, effusion, and infection. Two patients were found to have intramuscular venous thrombosis. All patients were followed up 10-54 months (mean, 29 months). Limp was observed at the early stage after operation in 9 patients and disappeared after 1 year, the other patients had normal gait. The VAS score 1.46±0.47, Harris score 88.66±3.48, and the leg length difference (1.15±0.33) cm at last follow-up all showed significant differences when compared with the preoperative values (P<0.05). No prosthesis loosening or subsidence, heterotopic ossification, dislocation, and infection occurred. Conclusion Anatomic femoral component prosthesis for severe DDH in THA can relieve pain, and improve the hip joint function and limb discrepancy. Short-term effectiveness was satisfactory, but the long-term effectiveness should still be observed in future.

Citation： ANXiao, DONGJiyuan, GONGKe, ZHANGQi, LIXiang, SONGWei. EFFECTIVENESS OF ANATOMIC FEMORAL COMPONENT PROSTHESIS FOR SEVERE DEVELOPMENTAL DYSPLASIA OF THE HIP IN TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 431-434. doi: 10.7507/1002-1892.20150093 Copy

1.	朱建辛, 王躍, 龐健, 等. 人工全髖關節置換術治療重度成人髖關節發育不良療效分析. 中國修復重建外科雜志, 2014, 28(3):335-338.
2.	宋立明, 張鐵良, 畢曉揚, 等. 嚴重髖關節發育不良的全髖關節置換術. 中華骨科雜志, 2010, 30(2):159-164.
3.	彭昊, 陳森, 鄭慧鋒, 等. 生物型假體全髖關節置換術治療成人髖關節發育不良繼發骨關節炎的療效評價. 中國矯形外科雜志, 2013, 21(15):1502-1507.
4.	Argenson JN, Flecher X, Parratte S, et al. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res, 2007, (465):40-45.
5.	Nakamura Y, Mitsui H, Kikuchi A, et al. Total hip arthroplasty using a cylindrical cementless stem in patients with a small physique. J Arthroplasty, 2011, 26(1):77-81.
6.	Faldini C, Miscione MT, Chehrassan M, et al. Congenital hip dysplasia treated by total hip arthroplasty using cementless tapered stem in patients younger than 50 years ol:results after 12-years follow-up. J Orthop Traumatol, 2011, 12(4):213-218.
7.	Biant LC, Bruce WJ, Assini JB, et al. Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem. J Arthroplasty, 2009, 24(1):27-32.
8.	Tamegai H, Otani T, Fujii H, et al. A modified S-ROM stem in primary total hip arthroplasty for developmental dysplasia of the hip. J Arthroplasty, 2013, 28 (10):1741-1745.
9.	Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1):45-55.
10.	Hodgkinson JP, Shelly P, Wroblewski BM. The correlation between the roentgenographic apperance and operative findings at the bone-cement junction of socket in Charnley low friction arthroplasties. Clin Orthop Relat Res, 1988, (228):105-109.
11.	Brooker A, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8):1629-1632.
12.	Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Re, 1979, (141):17-27.
13.	周建生, 王志巖, 官建中, 等. 成人髖關節發育不良髖臼解剖學特征及臨床意義. 中華解剖與臨床雜志, 2014, 19(1):2-6.
14.	Flecher X, PmTatte S, Brassart N, et al. Evaluation of the hip center in total hip arthroplasty for old developmental dysplasia. J Arthroplasty, 2008, 23(8):1189-1196.
15.	Stans AA, Pagnano MW, Shghnessy WJ, et al. Results of total hip arthroplasty for Crowe Type Ⅲ development hip dydplasia. Clinc Orthop Relat Res, 1998, (348):149-157.
16.	周耀輝, 黃文雅, 羅永發, 等. 全髖關節置換術在先天性髖臼發育不良繼發骨性關節炎的應用. 中國傷殘醫學, 2013, 21(4):5-7.
17.	Saito S, Ishii T, Mori S, et al. Long-term results of bulk femoral head autograft in cementless THA for developmental hip dysplasia. Orthopedics, 2011, 34(2):88.
18.	Argenson JN, Flecher X, Parratte S, et al. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res, 2007, (465):40-45.
19.	曹寅生, 盧敏, 姚共和, 等. 生物型全髖關節置換術治療成人髖關節發育不良29例回顧性分析. 中國骨傷, 2013, 26(11):962-965.
20.	劉明, 王巖, 陳繼營, 等. 1436髖Ribbed假體單中心應用分析. 中國矯形外科雜志, 2008, 16(14):1051-1053.
21.	蔣毅, 周一新, 郭盛杰, 等. 應用羥基磷灰石噴涂解剖型股骨假體的中期隨訪結果. 中華骨科雜志, 2009, 29(10):901-904.

1. 朱建辛, 王躍, 龐健, 等. 人工全髖關節置換術治療重度成人髖關節發育不良療效分析. 中國修復重建外科雜志, 2014, 28(3):335-338.
2. 宋立明, 張鐵良, 畢曉揚, 等. 嚴重髖關節發育不良的全髖關節置換術. 中華骨科雜志, 2010, 30(2):159-164.
3. 彭昊, 陳森, 鄭慧鋒, 等. 生物型假體全髖關節置換術治療成人髖關節發育不良繼發骨關節炎的療效評價. 中國矯形外科雜志, 2013, 21(15):1502-1507.
4. Argenson JN, Flecher X, Parratte S, et al. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res, 2007, (465):40-45.
5. Nakamura Y, Mitsui H, Kikuchi A, et al. Total hip arthroplasty using a cylindrical cementless stem in patients with a small physique. J Arthroplasty, 2011, 26(1):77-81.
6. Faldini C, Miscione MT, Chehrassan M, et al. Congenital hip dysplasia treated by total hip arthroplasty using cementless tapered stem in patients younger than 50 years ol:results after 12-years follow-up. J Orthop Traumatol, 2011, 12(4):213-218.
7. Biant LC, Bruce WJ, Assini JB, et al. Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem. J Arthroplasty, 2009, 24(1):27-32.
8. Tamegai H, Otani T, Fujii H, et al. A modified S-ROM stem in primary total hip arthroplasty for developmental dysplasia of the hip. J Arthroplasty, 2013, 28 (10):1741-1745.
9. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1):45-55.
10. Hodgkinson JP, Shelly P, Wroblewski BM. The correlation between the roentgenographic apperance and operative findings at the bone-cement junction of socket in Charnley low friction arthroplasties. Clin Orthop Relat Res, 1988, (228):105-109.
11. Brooker A, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8):1629-1632.
12. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Re, 1979, (141):17-27.
13. 周建生, 王志巖, 官建中, 等. 成人髖關節發育不良髖臼解剖學特征及臨床意義. 中華解剖與臨床雜志, 2014, 19(1):2-6.
14. Flecher X, PmTatte S, Brassart N, et al. Evaluation of the hip center in total hip arthroplasty for old developmental dysplasia. J Arthroplasty, 2008, 23(8):1189-1196.
15. Stans AA, Pagnano MW, Shghnessy WJ, et al. Results of total hip arthroplasty for Crowe Type Ⅲ development hip dydplasia. Clinc Orthop Relat Res, 1998, (348):149-157.
16. 周耀輝, 黃文雅, 羅永發, 等. 全髖關節置換術在先天性髖臼發育不良繼發骨性關節炎的應用. 中國傷殘醫學, 2013, 21(4):5-7.
17. Saito S, Ishii T, Mori S, et al. Long-term results of bulk femoral head autograft in cementless THA for developmental hip dysplasia. Orthopedics, 2011, 34(2):88.
18. Argenson JN, Flecher X, Parratte S, et al. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res, 2007, (465):40-45.
19. 曹寅生, 盧敏, 姚共和, 等. 生物型全髖關節置換術治療成人髖關節發育不良29例回顧性分析. 中國骨傷, 2013, 26(11):962-965.
20. 劉明, 王巖, 陳繼營, 等. 1436髖Ribbed假體單中心應用分析. 中國矯形外科雜志, 2008, 16(14):1051-1053.
21. 蔣毅, 周一新, 郭盛杰, 等. 應用羥基磷灰石噴涂解剖型股骨假體的中期隨訪結果. 中華骨科雜志, 2009, 29(10):901-904.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ANATOMIC FEMORAL COMPONENT PROSTHESIS FOR SEVERE DEVELOPMENTAL DYSPLASIA OF THE HIP IN TOTAL HIP ARTHROPLASTY

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