RECONSTRUCTION OF HIP CENTER IN TOTAL HIP ARTHROPLASTY FOR DEVELOPMENTAL DYSPLASIA OF HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Xiongfeng , GUAN Guohua , LI Jianyou.

Department of Orthopedics, Huzhou Central Hospital, Huzhou Zhejiang, 313000, P.R.China. Corresponding author: LI Xiongfeng, E-mail: lyfwind@126.com;

Corresponding author：

Keywords：

Developmental dysplasia of hip; Total hip arthroplasty; Hip center reconstruction

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ObjectiveTo explore the surgical technique and the effectiveness of reconstructing the hip center in total hip arthroplasty (THA) for developmental dysplasia of hip (DDH). MethodsBetween January 2004 and January 2010, 29 patients (32 hips) with DDH underwent THA. There were 6 males (6 hips) and 23 females (26 hips), aged 45-67 years (mean, 50.6 years). The locations were left side in 22 hips and right side in 10 hips. According to Crowe classification, 12 hips were rated as Crowe I and 20 hips as Crowe II. The patients had limb length discrepancy of 1.9-4.4 cm. The Harris score was 50.7 ± 8.6. ResultsAll incisions healed by first intension. Posterior hip dislocation occurred in 1 case (1 hip) after operation. All patients were followed up 2 years-4 years and 6 months (mean, 2.3 years). The lower limbs were lengthened by 0.5-5.8 cm (mean, 2.5 cm). The Harris score was 87.7 ± 5.9 at 1 year after operation, showing significant difference when compared with preoperative score (t=21.77, P=0.00). X-ray films showed loosening of acetabular component in 1 case (1 hip) and displacement of acetabular component with too large abduction angle in 1 case (1 hip); no loosening and subsidence of acetabular or femoral components occurred in the other patients during follow-up. The horizontal location of hip center, the vertical distance between teardrop and the hip center, the vertical acetabular abduction angle, and the femoral offset were better than those before operation (P lt; 0.05). ConclusionFor DDH patients, reconstructing the hip center in THA can lengthen the limb, improve the joint function, and reduce the failure rate of joint replacement.

Citation： LI Xiongfeng,GUAN Guohua,LI Jianyou.. RECONSTRUCTION OF HIP CENTER IN TOTAL HIP ARTHROPLASTY FOR DEVELOPMENTAL DYSPLASIA OF HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1037-1040. doi: Copy

1.	Anderson MJ, Harris WH. Total hip arthroplasty with insertion of the acetabular component without cement in hips with total congenital dislocation or marked congenital dysplasia. J Bone Joint Surg (Am), 1999, 81(3): 347-354.
2.	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.
3.	张晓岗, 杨德盛, 曹力. 非骨水泥型全髋关节置换术治疗成人发育性髋关节脱位. 中国修复重建外科杂志, 2008, 22(6): 649-652.
4.	赵秀祥, 于建华, 卜延民, 等. 股骨转子下截骨在Crowe Ⅳ型髋关节发育不良全髋关节置换中的应用. 中华骨科杂志, 2010, 30(2): 148-152.
5.	李彪, 龚跃昆, 张磊, 等. 生物型全髋关节置换术治疗成人髋关节发育不良. 中国修复重建外科杂志, 2008, 22(6): 646-648.
6.	Russotti GM, Harris WH. Proximal placement of the acetabular component in total hip arthroplasty. A long-term follow-up study. J Bone Joint Surg (Am), 1991, 73(4): 587-592.
7.	史振才, 李子荣. 髋关节发育不良全髋关节置换术的髋臼中心化. 中国医学科学院学报, 2004, 26(4): 446-450.
8.	Hirakawa K, Mitsugi N, Koshino T, et al. Effect of acetabular cup position and orientation in cemented total hip arthroplasty. Clin Orthop Relat Res, 2001, (388): 135-142.
9.	吴岳嵩, 汪滋民, 王志伟, 等. Crowe Ⅳ型髋关节发育不良的全髋关节置换术. 中华骨科杂志, 2010, 30(2): 129-136.
10.	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.
11.	Flecher X, Parratte 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.
12.	陈光兴, 杨柳, 古凌川, 等. 非短缩截骨全髋关节置换术治疗严重髋关节发育不良. 中华骨科杂志, 2010, 30(2): 137-142.
13.	Asayama I, Chamnongkich S, Simpson KJ, et al. Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty, 2005, 20(4): 414-420.
14.	Yoo MC, Cho YJ, Kim KI, et al. Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip. Clin Orthop Surg, 2009, 1(1): 19-26.
15.	Dandachli W, Nakhla A, Iranpeur F, et al. Can the acetabular position be derived from a pelvic frame of reference? Clin Orthop Relat Res, 2009, 467(4): 886-893.
16.	Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg (Am), 2007, 89(8): 1832-1842.

1. Anderson MJ, Harris WH. Total hip arthroplasty with insertion of the acetabular component without cement in hips with total congenital dislocation or marked congenital dysplasia. J Bone Joint Surg (Am), 1999, 81(3): 347-354.
2. 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.
3. 张晓岗, 杨德盛, 曹力. 非骨水泥型全髋关节置换术治疗成人发育性髋关节脱位. 中国修复重建外科杂志, 2008, 22(6): 649-652.
4. 赵秀祥, 于建华, 卜延民, 等. 股骨转子下截骨在Crowe Ⅳ型髋关节发育不良全髋关节置换中的应用. 中华骨科杂志, 2010, 30(2): 148-152.
5. 李彪, 龚跃昆, 张磊, 等. 生物型全髋关节置换术治疗成人髋关节发育不良. 中国修复重建外科杂志, 2008, 22(6): 646-648.
6. Russotti GM, Harris WH. Proximal placement of the acetabular component in total hip arthroplasty. A long-term follow-up study. J Bone Joint Surg (Am), 1991, 73(4): 587-592.
7. 史振才, 李子荣. 髋关节发育不良全髋关节置换术的髋臼中心化. 中国医学科学院学报, 2004, 26(4): 446-450.
8. Hirakawa K, Mitsugi N, Koshino T, et al. Effect of acetabular cup position and orientation in cemented total hip arthroplasty. Clin Orthop Relat Res, 2001, (388): 135-142.
9. 吴岳嵩, 汪滋民, 王志伟, 等. Crowe Ⅳ型髋关节发育不良的全髋关节置换术. 中华骨科杂志, 2010, 30(2): 129-136.
10. 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.
11. Flecher X, Parratte 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.
12. 陈光兴, 杨柳, 古凌川, 等. 非短缩截骨全髋关节置换术治疗严重髋关节发育不良. 中华骨科杂志, 2010, 30(2): 137-142.
13. Asayama I, Chamnongkich S, Simpson KJ, et al. Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty, 2005, 20(4): 414-420.
14. Yoo MC, Cho YJ, Kim KI, et al. Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip. Clin Orthop Surg, 2009, 1(1): 19-26.
15. Dandachli W, Nakhla A, Iranpeur F, et al. Can the acetabular position be derived from a pelvic frame of reference? Clin Orthop Relat Res, 2009, 467(4): 886-893.
16. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg (Am), 2007, 89(8): 1832-1842.

Chinese Journal of Reparative and Reconstructive Surgery

RECONSTRUCTION OF HIP CENTER IN TOTAL HIP ARTHROPLASTY FOR DEVELOPMENTAL DYSPLASIA OF HIP

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