IMAGING ANALYSIS OF ACETABULAR CUP POSITIONS IN TOTAL HIP ARTHROPLASTY FOR ADULTS WITH ACETABULAR DYSPLASIA_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SUNHong , FANGShuying , YANGZibo , ZHANGZhiqi , KANGYan , ZHANGZiji , LIAOWeiming , FUMing ,  WUPeihui

Department of Joint Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Guangdong, 510080, P.R.China;

Corresponding author：

WUPeihui, Email: wupeihui@mail2.sysu.edu.cn

Keywords：

Developmental dysplasia of hip; Total hip arthroplasty; Acetabular cup position; Crowe classification; Learning curve; Adult

DOI：

10.7507/1002-1892.20160276

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Objective To investigate the influence of the degree of acetabular deformity and the learning-curve on the acetabular cup positions in total hip arthroplasty (THA) for adults with developmental dysplasia of hip (DDH). Methods Between January 2008 and December 2015, 130 patients (144 hips) with DDH underwent primary THA, and the clinical data were analyzed retrospectively. Fifty-three patients (59 hips) were admitted before 2012, and 77 patients (85 hips) were treated after 2012. There were 32 males and 98 females, aged from 31 to 83 years (mean, 61). Unilateral replacement was performed in 116 cases and bilateral replacement in 14 cases. Of 144 hips, 48 hips were rated as Crowe type I, 57 hips as type II, and 39 hips as type of III/IV. The standard pelvic radiograph was taken within 1 week after operation. The mediCAD software was adopted to measure the angle of anteversion and abduction, bony coverage, and the distance between true rotating center and optimal rotating center to the connection of teardrops and the horizontal distance between two centers to evaluate the qualified rate of acetabular cup positions. Results Compared with the patients with the same type in 2013-2015 group, the anteversion angle and qualified rate of acetabular cup position significantly decreased in patients with Crowe I (P < 0.05); the horizontal distance significantly increased and qualified rate of acetabular cup position significantly decreased in patients with Crowe II (P < 0.05); and the anteversion angle significantly decreased and the horizontal distance significantly increased in patients with Crowe III/IV (P < 0.05) in 2008-2012 group. But no significant difference was shown in the other indexes (P > 0.05). In all Crowe types, the vertical distance between the true rotating center and the optimal rotating center increased with the degree of acetabular deformity in both 2008-2012 group and 2013-2015 group, showing significant difference (P < 0.05), but no significant difference was found in the other indexes (P > 0.05). Conclusion For adults with acetabular dysplasia, there are high potential risks for unsatisfactory acetabular cup positions during primary THA. So it is necessary to evaluate acetabular deformities and to sum up operative experience so as to improve the accuracy of cups installation.

Citation： SUNHong, FANGShuying, YANGZibo, ZHANGZhiqi, KANGYan, ZHANGZiji, LIAOWeiming, FUMing, WUPeihui. IMAGING ANALYSIS OF ACETABULAR CUP POSITIONS IN TOTAL HIP ARTHROPLASTY FOR ADULTS WITH ACETABULAR DYSPLASIA. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(11): 1349-1353. doi: 10.7507/1002-1892.20160276 Copy

1.	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.
2.	Harris-Hayes M, Royer NK. Relationship of acetabular dysplasia and femoroacetabular impingement to hip osteoarthritis: a focused review. PM R, 2011, 3(11): 1055-1067.e1.
3.	Pagnano W, Hanssen AD, Lewallen DG, et al. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(7): 1004-1014.
4.	Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
5.	Bicanic G, Delimar D, Delimar M, et al. Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop, 2009, 33(2): 397-402.
6.	潘浩, 胡庆丰, 肖鲁伟, 等.髋关节发育不良髋臼假体位置与稳定的三维有限元分析.浙江医学, 2015, 37(1): 44-48.
7.	Stans AA, Pagnano MW, Shaughnessy WJ, et al. Results of total hip arthroplasty for Crowe Type III developmental hip dysplasia. Clin Orthop Relat Res, 1998, (348): 149-157.
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.	肖瑜, 张福江, 马信龙, 等.成人髋关节发育不良不同Crowe分型的三维CT影像学特征.中华骨科杂志, 2014, 34(3): 311-316.
10.	Abdel MP, Stryker LS, Trousdale RT, et al. Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years. J Bone Joint Surg (Am), 2014, 96(22): 1878-1882.
11.	张志奇, 廖威明, 侯昌禾, 等.变异髋臼人工全髋关节置换中髋臼假体选择性上移安置的初步疗效分析.中国修复重建外科杂志, 2014, 28(5): 566-570.
12.	黄志宇, 张志奇, 傅明, 等.髋臼假体上移放置对髋关节发育不良全髋关节置换术后下肢长度及功能的影响.中华骨科杂志, 2014, 34(12): 1225-1230.
13.	Nawabi DH, Meftah M, Nam D, et al. Durable fixation achieved with medialized, high hip center cementless THAs for Crowe II and III dysplasia. Clin Orthop Relat Res, 2014, 472(2): 630-636.
14.	Zhao X, Zhu ZA, Zhao J, et al. The utility of digital templating in Total Hip Arthroplasty with Crowe type II and III dysplastic hips. Int Orthop, 2011, 35(5): 631-638.
15.	Sariali E, Mauprivez R, Khiami F, et al. Accuracy of the preoperative planning for cementless total hip arthroplasty. A randomised comparison between three-dimensional computerised planning and conventional templating. Orthop Traumatol Surg Res, 2012, 98(2): 151-158.
16.	曾羿, 赖欧杰, 沈彬, 等.计算机三维术前计划在CroweⅣ型髋关节发育不良全髋关节置换髋臼重建中的应用.中华骨科杂志, 2014, 34(12): 1212-1218.
17.	Sariali E, Boukhelifa N, Catonne Y, et al. Comparison of three-dimensional planning-assisted and conventional acetabular cup positioning in total hip arthroplasty: a randomized controlled trial. J Bone Joint Surg (Am), 2016, 98(2): 108-116.
18.	Parratte S, Argenson JN. Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg (Am), 2007, 89(3): 494-499.
19.	Hananouchi T, Saito M, Koyama T, et al. Tailor-made surgical guide based on rapid prototyping technique for cup insertion in total hip arthroplasty. Int J Med Robot, 2009, 5(2): 164-169.

1. 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.
2. Harris-Hayes M, Royer NK. Relationship of acetabular dysplasia and femoroacetabular impingement to hip osteoarthritis: a focused review. PM R, 2011, 3(11): 1055-1067.e1.
3. Pagnano W, Hanssen AD, Lewallen DG, et al. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(7): 1004-1014.
4. Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
5. Bicanic G, Delimar D, Delimar M, et al. Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop, 2009, 33(2): 397-402.
6. 潘浩, 胡庆丰, 肖鲁伟, 等.髋关节发育不良髋臼假体位置与稳定的三维有限元分析.浙江医学, 2015, 37(1): 44-48.
7. Stans AA, Pagnano MW, Shaughnessy WJ, et al. Results of total hip arthroplasty for Crowe Type III developmental hip dysplasia. Clin Orthop Relat Res, 1998, (348): 149-157.
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. 肖瑜, 张福江, 马信龙, 等.成人髋关节发育不良不同Crowe分型的三维CT影像学特征.中华骨科杂志, 2014, 34(3): 311-316.
10. Abdel MP, Stryker LS, Trousdale RT, et al. Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years. J Bone Joint Surg (Am), 2014, 96(22): 1878-1882.
11. 张志奇, 廖威明, 侯昌禾, 等.变异髋臼人工全髋关节置换中髋臼假体选择性上移安置的初步疗效分析.中国修复重建外科杂志, 2014, 28(5): 566-570.
12. 黄志宇, 张志奇, 傅明, 等.髋臼假体上移放置对髋关节发育不良全髋关节置换术后下肢长度及功能的影响.中华骨科杂志, 2014, 34(12): 1225-1230.
13. Nawabi DH, Meftah M, Nam D, et al. Durable fixation achieved with medialized, high hip center cementless THAs for Crowe II and III dysplasia. Clin Orthop Relat Res, 2014, 472(2): 630-636.
14. Zhao X, Zhu ZA, Zhao J, et al. The utility of digital templating in Total Hip Arthroplasty with Crowe type II and III dysplastic hips. Int Orthop, 2011, 35(5): 631-638.
15. Sariali E, Mauprivez R, Khiami F, et al. Accuracy of the preoperative planning for cementless total hip arthroplasty. A randomised comparison between three-dimensional computerised planning and conventional templating. Orthop Traumatol Surg Res, 2012, 98(2): 151-158.
16. 曾羿, 赖欧杰, 沈彬, 等.计算机三维术前计划在CroweⅣ型髋关节发育不良全髋关节置换髋臼重建中的应用.中华骨科杂志, 2014, 34(12): 1212-1218.
17. Sariali E, Boukhelifa N, Catonne Y, et al. Comparison of three-dimensional planning-assisted and conventional acetabular cup positioning in total hip arthroplasty: a randomized controlled trial. J Bone Joint Surg (Am), 2016, 98(2): 108-116.
18. Parratte S, Argenson JN. Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study. J Bone Joint Surg (Am), 2007, 89(3): 494-499.
19. Hananouchi T, Saito M, Koyama T, et al. Tailor-made surgical guide based on rapid prototyping technique for cup insertion in total hip arthroplasty. Int J Med Robot, 2009, 5(2): 164-169.

Chinese Journal of Reparative and Reconstructive Surgery

IMAGING ANALYSIS OF ACETABULAR CUP POSITIONS IN TOTAL HIP ARTHROPLASTY FOR ADULTS WITH ACETABULAR DYSPLASIA

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