SHORT-TERM EFFECTIVENESS OF Total HIP ARTHROPLASTY WITH A TAPERED, MODULAR NECK HIP STEM FOR DEVELOPMENTAL DYSPlASIA OF THE HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FUWen ,  XUYaozeng , GENGDechun , YANGTongqi , HUANGLixin , LIRongqun , CUIJingfu , ZHUShijun , ZHUFeng

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

Corresponding author：

XUYaozeng, Email: xuyaozeng@163.com

Keywords：

Developmental dysplasia of the hip; Tapered; modular neck hip stem; Total hip arthroplasty

DOI：

10.7507/1002-1892.20140097

Video：

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Objective To analyze and summarize the short-term effectiveness of total hip arthroplasty (THA) with a tapered, modular neck hip stem for developmental dysplasia of the hip (DDH). Methods Between October 2010 and May 2012, 28 patients (31 hips) with DDH and secondary osteoarthritis underwent THA with a tapered, modular neck hip stem. There were 2 males and 26 females, with an average age of 61 years (range, 47-77 years). The unilateral hip was involved in 25 cases and bilateral hips in 3 cases. According to the Crowe system, 22 cases were classified as Crowe type I, 8 as Crowe type Ⅱ, and 1 as Crowe type Ⅲ. At preoperation, the leg length discrepancy was (1.6±0.8) cm; the hip range of motion values were (76.1±12.8)° in flexion, (14.5±6.7)° in abduction, (9.0±4.5)° in adduction, (13.1±6.4)° in internal rotation, and (11.7±7.0)° in external rotation; and the Harris hip score was 44.7±11.1. Results Femoral neck fracture occurred in 2 cases (2 hips) during operation, which healed by fixed with steel wire. The incisions healed by first intention. No related complication occurred. The mean follow-up time was 20 months (range, 12-32 months). At last follow-up, the leg length discrepancy was significant decreased to (1.0±0.5) cm (t=-3.512, P=0.002). The hip range of motion values were (102.9±10.1)° in flexion, (32.9±6.0)° in abduction, (19.2±4.3)° in adduction, (34.4±4.2)° in internal rotation, and (32.3±5.1)° in external rotation, all showing significant differences when compared with preoperative values (P<0.05). The Harris hip score was significantly improved to 90.3±6.1 (t=21.263, P=0.000). The X-ray films showed no subsidence, loosening, or breakage in the other cases except 2 cases having subsidence (<2 mm) within 1 year. Heterotopic ossification occurred in 2 hips. Conclusion The short-term effectiveness of THA with a tapered, modular neck hip stem for DDH is satisfactory. However, the medium and long-term effectiveness still need further follow-up.

Citation： FUWen, XUYaozeng, GENGDechun, YANGTongqi, HUANGLixin, LIRongqun, CUIJingfu, ZHUShijun, ZHUFeng. SHORT-TERM EFFECTIVENESS OF Total HIP ARTHROPLASTY WITH A TAPERED, MODULAR NECK HIP STEM FOR DEVELOPMENTAL DYSPlASIA OF THE HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 428-431. doi: 10.7507/1002-1892.20140097 Copy

1.	Jacobsen S, Sonne-Holm S. Hip dysplasia:a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey. Rheumatology, 2005, 44(2):211-218.
2.	Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet, 2007, 369(9572):1541-1552.
3.	Rogers BA, Garbedian S, Kuchinad RA, et al. Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg (Am), 2012, 94(19):1809-1821.
4.	Duwelius PJ, Hartzband MA, Burkhart R, et al. Clinical results of a modular neck hip system:hitting the ‘bull’s-eye' more accurately. Am J Orthop (Belle Mead NJ), 2010, 39(10 Suppl):2-6.
5.	Takao M, Ohzono K, Nishii T, et al. Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia. J Bone Joint Surg (Am), 2011, 93(6):548-555.
6.	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.
7.	李文波, 张文明, 白国昌, 等. 人工全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良伴脱位. 中国修复重建外科杂志, 2013, 27(10):1153-1156.
8.	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.
9.	Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty. J Bone Joint Surg (Am), 1969, 51(4):737-755.
10.	Petersilge WJ, D'Lima DD, Walker RH, et al. Prospective study of 100 consecutive Harris-Galante porous total hip arthroplasties. 4-to 8-year followup study. J Arthroptasty, 1997, 12(2):185-193.
11.	Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res, 1990, (257):107-128.
12.	Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stern-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141):17-27.
13.	Callaghan JJ, Salvati EA, Pellici PM, et al. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg (Am), 1985, 67(7):1074-1085.
14.	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.
15.	DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976, (121):20-32.
16.	Brooker AF, 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.
17.	Duncan CP, Masri BA. Fractures of the femur after hip replacement. Instr Course Lect, 1995, 44:293-304.
18.	Massin P, Geais L, Astoin E, et al. The anatomic basis for the concept of lateralized femoral stems:a frontal plane radiographic study of the proximal femur. J Arthroplasty, 2000, 15(1):93-101.
19.	Archibeck MJ, Cunnins T, Carothers J, et al. A comparison of two implant systems in restoration of hip geometry in arthroplasty. Clin Orthop Relat Res, 2011, 469(2):443-446.
20.	王守立, 吴海山, 陈宜, 等. 组配式假体全髋关节置换术重建双下肢等长. 中华关节外科杂志(电子版), 2012, 6(6):867-871.
21.	陈宜, 吴宇黎, 祝云利, 等. 股骨颈组配式假体在全髋关节置换术后偏心距重建中的作用. 中华骨科杂志, 2013, 33(9):901-905.
22.	Yoder SA, Brand RA, Pedersen DR, et al. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res, 1988, (228):79-87.
23.	Cameron HU, Botsford DJ, Park YS. Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty, 1996, 11(5):582-587.
24.	Wolfgang GL. Femoral head autografting with total hip arthroplasty for lateral acetabular dysplasia. A 12-year experience. Clin Orthop Relat Res, 1990, (255):173-185.
25.	Schüller HM, Dalstra M, Huiskes R, et al. Total hip reconstruction in acetabular dysplasia. A finite element study. J Bone Joint Surg (Br), 1993, 75(3):468-474.
26.	Christie MJ, DeBoer DK, Trick LW, et al. Primary total hip arthroplasty with use of the modular S-ROM prosthesis. Four to seven-year clinical and radiographic results. J Bone Joint Surg (Am), 1999, 81(12):1707-1716.
27.	Sporer SM, DellaValle C, Jacobs J, et al. A case of disassociation of a modular femoral neck trunion after total hip arthroplasty. J Arthroplasty, 2006, 21(6):918-921.
28.	Wright G, Sporer S, Urban R, et al. Fracture of a modular femoral neck after total hip arthroplasty:a case report. J Bone Joint Surg (Am), 2010, 92(6):1518-1521.
29.	Wilson DA, Dunbar MJ, Amirault JD, et al. Early failure of a modular femoral neck total hip arthroplasty component:a case report. J Bone Joint Surg (Am), 2010, 92(6):1514-1517.
30.	Atwood SA, Patten EW, Bozic KJ, et al. Corrosion-induced fracture of a double-modular hip prosthesis:a case report. J Bone Joint Surg (Am), 2010, 92(6):1522-1525.

1. Jacobsen S, Sonne-Holm S. Hip dysplasia:a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey. Rheumatology, 2005, 44(2):211-218.
2. Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet, 2007, 369(9572):1541-1552.
3. Rogers BA, Garbedian S, Kuchinad RA, et al. Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg (Am), 2012, 94(19):1809-1821.
4. Duwelius PJ, Hartzband MA, Burkhart R, et al. Clinical results of a modular neck hip system:hitting the ‘bull’s-eye' more accurately. Am J Orthop (Belle Mead NJ), 2010, 39(10 Suppl):2-6.
5. Takao M, Ohzono K, Nishii T, et al. Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia. J Bone Joint Surg (Am), 2011, 93(6):548-555.
6. 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.
7. 李文波, 张文明, 白国昌, 等. 人工全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良伴脱位. 中国修复重建外科杂志, 2013, 27(10):1153-1156.
8. 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.
9. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty. J Bone Joint Surg (Am), 1969, 51(4):737-755.
10. Petersilge WJ, D'Lima DD, Walker RH, et al. Prospective study of 100 consecutive Harris-Galante porous total hip arthroplasties. 4-to 8-year followup study. J Arthroptasty, 1997, 12(2):185-193.
11. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res, 1990, (257):107-128.
12. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stern-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141):17-27.
13. Callaghan JJ, Salvati EA, Pellici PM, et al. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg (Am), 1985, 67(7):1074-1085.
14. 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.
15. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976, (121):20-32.
16. Brooker AF, 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.
17. Duncan CP, Masri BA. Fractures of the femur after hip replacement. Instr Course Lect, 1995, 44:293-304.
18. Massin P, Geais L, Astoin E, et al. The anatomic basis for the concept of lateralized femoral stems:a frontal plane radiographic study of the proximal femur. J Arthroplasty, 2000, 15(1):93-101.
19. Archibeck MJ, Cunnins T, Carothers J, et al. A comparison of two implant systems in restoration of hip geometry in arthroplasty. Clin Orthop Relat Res, 2011, 469(2):443-446.
20. 王守立, 吴海山, 陈宜, 等. 组配式假体全髋关节置换术重建双下肢等长. 中华关节外科杂志(电子版), 2012, 6(6):867-871.
21. 陈宜, 吴宇黎, 祝云利, 等. 股骨颈组配式假体在全髋关节置换术后偏心距重建中的作用. 中华骨科杂志, 2013, 33(9):901-905.
22. Yoder SA, Brand RA, Pedersen DR, et al. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res, 1988, (228):79-87.
23. Cameron HU, Botsford DJ, Park YS. Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty, 1996, 11(5):582-587.
24. Wolfgang GL. Femoral head autografting with total hip arthroplasty for lateral acetabular dysplasia. A 12-year experience. Clin Orthop Relat Res, 1990, (255):173-185.
25. Schüller HM, Dalstra M, Huiskes R, et al. Total hip reconstruction in acetabular dysplasia. A finite element study. J Bone Joint Surg (Br), 1993, 75(3):468-474.
26. Christie MJ, DeBoer DK, Trick LW, et al. Primary total hip arthroplasty with use of the modular S-ROM prosthesis. Four to seven-year clinical and radiographic results. J Bone Joint Surg (Am), 1999, 81(12):1707-1716.
27. Sporer SM, DellaValle C, Jacobs J, et al. A case of disassociation of a modular femoral neck trunion after total hip arthroplasty. J Arthroplasty, 2006, 21(6):918-921.
28. Wright G, Sporer S, Urban R, et al. Fracture of a modular femoral neck after total hip arthroplasty:a case report. J Bone Joint Surg (Am), 2010, 92(6):1518-1521.
29. Wilson DA, Dunbar MJ, Amirault JD, et al. Early failure of a modular femoral neck total hip arthroplasty component:a case report. J Bone Joint Surg (Am), 2010, 92(6):1514-1517.
30. Atwood SA, Patten EW, Bozic KJ, et al. Corrosion-induced fracture of a double-modular hip prosthesis:a case report. J Bone Joint Surg (Am), 2010, 92(6):1522-1525.

Chinese Journal of Reparative and Reconstructive Surgery

SHORT-TERM EFFECTIVENESS OF Total HIP ARTHROPLASTY WITH A TAPERED, MODULAR NECK HIP STEM FOR DEVELOPMENTAL DYSPlASIA OF THE HIP

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