Posterosuperior Placement of a Standard-Sized Cup at the True Acetabulum in Acetabular Reconstruction of Developmental Dysplasia of the Hip With High Dislocation

Abstract Background We sought to evaluate posterosuperior placement of the acetabular component at the true acetabulum during acetabular reconstruction in patients with Crowe type-IV developmental dysplasia of the hip. Methods Using pelvic computed tomography and image processing, we developed a two...

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Bibliographic Details
Published in:The Journal of arthroplasty 2016-06, Vol.31 (6), p.1233-1239
Main Authors: Xu, Jiawei, MD, Xu, Chen, MD, Mao, Yuanqing, MD, PhD, Zhang, Jincheng, MD, PhD, Li, Huiwu, MD, PhD, Zhu, Zhenan, MD, PhD
Format: Article
Language:English
Subjects:
Acetabulum - diagnostic imaging
Acetabulum - surgery
Adult
Aged
anatomic acetabular reconstruction
Arthroplasty, Replacement, Hip - methods
Bone Cements
Ceramics
developmental dysplasia of the hip with high dislocation
Female
Hip Dislocation - diagnostic imaging
Hip Dislocation - surgery
Hip Dislocation, Congenital - diagnostic imaging
Hip Dislocation, Congenital - surgery
Humans
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Male
Middle Aged
Orthopedics
Pelvis - diagnostic imaging
Pelvis - surgery
posterosuperior cup placement
three-dimensional coverage
Tomography, X-Ray Computed
total hip arthroplasty
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Summary:Abstract Background We sought to evaluate posterosuperior placement of the acetabular component at the true acetabulum during acetabular reconstruction in patients with Crowe type-IV developmental dysplasia of the hip. Methods Using pelvic computed tomography and image processing, we developed a two-dimensional mapping technique to demonstrate the distribution of preoperative three-dimensional cup coverage at the true acetabulum, determined the postoperative location of the acetabular cup, and calculated postoperative three-dimensional coverage for 16 Crowe type-IV dysplastic hips in 14 patients with a mean age of 52 years (33-78 years) who underwent total hip arthroplasty. Mean follow-up was 6.3 years (5.5-7.3 years). Results On preoperative mapping, the maximum three-dimensional coverage using a 44-mm cup was 87.31% (77.36%-98.14%). Mapping enabled the successful replacement of 16 hips using a mean cup size of 44.13 mm (42-46 mm) with posterosuperior placement of the cup. Early weight-bearing and no prosthesis revision or loosening during follow-up were achieved in all patients. The postoperative two-dimensional coverage on anteroposterior radiographs and three-dimensional coverage were 96.15% (89.49%-100%) and 83.42% (71.81%-98.50%), respectively. Conclusion This technique may improve long-term implant survival in patients with Crowe-IV developmental dysplasia of the hip undergoing total hip arthroplasty by allowing the use of durable bearings, increasing host bone coverage, ensuring initial stability, and restoring the normal hip center.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2015.12.019