Medical Principles and Practice
Original Paper
Total Hip Arthroplasty in Acetabular Deficiency: Experience in Al Razi Hospital, KuwaitPospula W. · Noor T.A.Department of Orthopedics, Al Razi Hospital, Kuwait
Wieslaw Pospula, MD, PhD Al Razi Orthopedic Hospital PO Box 4235 13043 Safat (Kuwait) Tel. +965 917 4515, Fax +965 482 2240, E-Mail pospulawieslaw@hotmail.com |
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Abstract
Objective: To report clinical and radiological outcomes of cemented and cementless total hip arthroplasty for primary and secondary osteoarthritis with a deficiency of acetabular bone stock. Subject and Methods: Thirty-seven patients (16 male and 21 female) having 41 hips affected by primary and secondary acetabular bone stock defect that were operated using cemented (n = 25) and cementless (n = 16) hip replacement were followed for an average period of 37 (range 12–100) months. Bone defect was classified according to American Academy of Orthopedic Surgery criteria. Different types of bone graft techniques and metal reinforcements were used. Merle d’Aubigné clinical score was used to calculate clinical outcomes. Geometrical position of the acetabular component, cup integration, hip center and graft integration were assessed. Results: The mean clinical score improved significantly from 10.6 patients preoperatively to 16.7 patients postoperatively; 95% of the cups were in the desired position and were considered integrated and the bone graft remodeled in most cases. There were 2 deep infections, 1 dislocation and 2 cases of transient neurological deficit. No significant differences in final clinical and radiological outcomes, rate of loosening and rate of complications were found between cemented and cementless acetabular replacements.Conclusion: The results show that reconstruction of acetabular bone deficiency can be accomplished with few complications using either a cemented or cementless acetabular component with or without grafting according to the clinical situation.
© 2007 S. Karger AG, Basel
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References
-
Cucker JM: Management strategies for acetabular defects in revision total hip arthroplasty. J Arthroplasty 2002;4(suppl 1):153–156.
External Resources
-
Hartofilakidis G, Karachalios T: Total hip arthroplasty for congenital hip disease. J Bone Joint Surg Am 2004;86A:242–250.
External Resources
- Weber M, Berry DJ, Harmsen WS: Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg Am 1998;80:1295–1305.
-
Murphy S: Management of acetabular bone stock deficiency. J Arthroplasty 2005;4(suppl 2):85–90.
External Resources
- Paprosky WG, Perona PG, Lawrence JM: Acetabular defect classification and surgical reconstruction in revision arthroplasty. J Arthroplasty 1994;9:33–44.
- Gozzard C, Blom A, Smith E, Learmonth I: A comparison of the reliability and validity of bone stock loss classification systems used for revision hip surgery. J Arthroplasty 2003;18:638–642.
- Boldt JG, Dilawari P, Agarwal S, Drabu KJ: Revision total hip arthroplasty using impaction bone grafting with cemented nonpolished stems and charnley cups. J Arthroplasty 2001;16:943–952.
- Dearborn JT, Harris WH: High placement of an acetabular component inserted without cement in a revision total hip arthroplasty after a mean of ten years. J Bone Joint Surg Am 1999;81:469–480.
- Chen WM, Engh CA Jr, Hopper RH Jr, McAuley JP, Engh CA: Acetabular revision with use of a bilobed component inserted without cement in patients who have acetabular stock deficiency. J Bone Joint Surg Am 2000;82:197–206.
- Unger AS, Levis RJ, Gruen T: Evaluation of porous tantalum uncemented acetabular cup in revision total hip arthroplasty: clinical and radiological results of 60 hips. J Arthroplasty 2005;20:1002–1009.
-
d’Aubigné MR, Postel M: Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 1954;76:129–138.
External Resources
- Campbell DG, Garbuz DS, Masri BA, Duncan C: Reliability of acetabular bone defect classification systems in revision total hip arthroplasty. J Arthroplasty 2001;16:83–86.
-
Schlegel UJ, Bitsch RG, Pritsch M, Clauss M, Mau H, Breusch S: Mueller reinforcement rings in acetabular revision: outcome in 164 hips followed for 2–17 years. Acta Orthop 2006;77:234–241.
External Resources
-
Grubl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F: Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup. J Bone Joint Surg Am 2002;84A:425–431.
External Resources
-
Bellabarba C, Berger RA, Bentley CD, Quigley MS, Jacobs JJ, Rosenberg AG, Sheinkop MB, Galante J: Cementless acetabular reconstruction after acetabular fracture. J Bone J Surg Am 2001;83A:868–876.
External Resources
- Joshi AB, Lee J, Christensen C: Results for custom acetabular component for acetabular deficiency. J Arthroplasty 2002;17:643–648.
- Bozic K, Freiberg A, Harris W: The high hip center. Clin Orthop Relat Res 2004;420:101–105.
- Morag G, Zalzal P, Liberman B, Safir O, Flint M, Gross AE: Outcome of revision hip arthroplasty in patients with previous total hip replacement for developmental dysplasia of the hip. J Bone Joint Surg Br 2005;87:1068–1072.
- Clohisy JC, Harris WH: Matched-pair analysis of cemented and cementless acetabular reconstruction in primary total hip arthroplasty. J Arthroplasty 2001;16:697–705.
Article / Publication Details
Received: August 07, 2006
Accepted: November 29, 2006
Published online: August 17, 2007
Issue release date: August 2007
Number of Print Pages: 5
Number of Figures: 5
Number of Tables: 1
ISSN: 1011-7571 (Print)
eISSN: 1423-0151 (Online)
For additional information: https://www.karger.com/MPP
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