Long-term retrospective study on the placement of the cementless acetabular cup and clinical outcomes in patients undergoing femoral head autografting for hip dysplasia and total hip arthroplasty
| Autor: | Burak Beksaç, Goksel Dikmen, Ismail Remzi Tozun, Vahit Emre Ozden |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Time Factors genetic structures Arthroplasty Replacement Hip Radiography medicine.medical_treatment Kaplan-Meier Estimate Prosthesis Design Transplantation Autologous 03 medical and health sciences Femoral head 0302 clinical medicine medicine Hip Dislocation Humans Orthopedics and Sports Medicine In patient 030212 general & internal medicine Survival rate Retrospective Studies Hip dysplasia 030222 orthopedics Bone Transplantation business.industry Acetabulum Femur Head Retrospective cohort study Middle Aged musculoskeletal system medicine.disease Arthroplasty Prosthesis Failure Surgery Transplantation Treatment Outcome surgical procedures operative medicine.anatomical_structure Female Hip Prosthesis sense organs business |
| Zdroj: | Journal of Orthopaedic Science. 23:525-531 |
| ISSN: | 0949-2658 |
| DOI: | 10.1016/j.jos.2018.02.009 |
| Popis: | Background Placement of acetabular cup in the dysplastic hip is a challenging procedure. Using bulk femoral head autograft to increase the bony coverage of the cup is one of the techniques, which have been described. The impact of cup position on cup and autograft survival is a controversial issue. We aimed to determine whether the position of cementless acetabular cup used in conjunction with femoral head autograft in dysplastic hips affected the autograft-host incorporation with its final radiographic appearance and the cup survivorship into the second decade. Methods Thirty-eight dysplastic hips with varying Crowe types in 31 patients (30 women and one man) were included. The mean age was 47 years (range, 29–64 years) and the mean follow-up was 20.3 years (range, 14.8–25.9 years). The initial postoperative and final radiographs were evaluated. The survival rate of the cups was analysed using Kaplan–Meier statistics and the log-rank test. Multivariate analysis was used to evaluate the effect of variables (Crowe type, radiographic initial host bone coverage over the cup and position of the cup) on survivorship. Results The acetabular cups were positioned anatomical in 27/38 hips according to Ranawat measurement technique. Trabecular bridging at graft–host interface was seen in all cases at an average 22.1 months. Neither acetabular cup position nor initial host bone coverage over acetabular cup less than 50% had any significant effect on either cup survival or final radiographic appearance of the graft. The 20-year cup survival rate without aseptic revision was 66% (95 CI, 52%–84%). No revision was performed due to graft resorption. Conclusion Twenty-year survival rate of the cementless cup combination with femoral head autograft showed no significant differences whether it was placed at high or anatomic hip centre. The final radiographic appearance of the autograft was not affected from either the cup location or the initial radiographic horizontal host bone coverage. |
| Databáze: | OpenAIRE |
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