|Custom cementless THA in patients with skeletal dysplasia results in lower apparent revision rates than other types of femoral fixation.|
|PMID: 21042892 Owner: NLM Status: MEDLINE|
|BACKGROUND: Patients with skeletal dysplasia are prone to degenerative hip disease thus requiring THA at a younger age than the general population. This is a technically demanding procedure with high complication and revision rates. Achieving good femoral fixation can be challenging because of the abnormal features of the hip.
QUESTIONS/PURPOSES: We therefore determined: (1) survivorship, (2) function, (3) radiographic findings, and (4) complications associated with a cementless custom-made femoral component used in THAs for patients with skeletal dysplasia and compared these parameters with those from other types of femoral fixation.
PATIENTS AND METHODS: Between 1992 and 2005, 40 THAs were performed in 25 patients with skeletal dysplasia using custom-made cementless femoral components. There were 15 men and 10 women with a mean age of 37.5 years (range, 18-61 years) and a mean height of 145 cm (range, 120-173 cm). Patients were followed clinically and radiographically for a minimum of 4.3 years (mean, 10.1 years; range, 4.3-18.2 years).
RESULTS: The survivorship rates for the femoral and acetabular components were 92% and 70%, respectively, at 220 months. Revision arthroplasty was performed in four of 40 hips (10%). In two, the acetabular component was revised for aseptic loosening, one had both components revised for aseptic loosening, and one had an isolated femoral component revision for deep infection. The mean Harris hip score improved from 41 (range, 27-57) preoperatively to 80 (range, 51-94) at final followup. There were two intraoperative proximal femoral fractures and one dislocation.
CONCLUSIONS: When compared with studies with equal followup, custom-made cementless components in THAs for patients with skeletal dysplasia apparently had lower revision and complication rates with comparable function and higher midterm survival.
|Mathew D Sewell; Sammy A Hanna; Sarah K Muirhead-Allwood; Stephen R Cannon; Timothy W R Briggs|
|Type: Comparative Study; Journal Article Date: 2010-11-02|
|Title: Clinical orthopaedics and related research Volume: 469 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2011 May|
|Created Date: 2011-04-01 Completed Date: 2011-06-07 Revised Date: 2013-07-03|
Medline Journal Info:
|Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States|
|Languages: eng Pagination: 1406-12 Citation Subset: AIM; IM|
|Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. email@example.com|
|APA/MLA Format Download EndNote Download BibTex|
Arthroplasty, Replacement, Hip / adverse effects, instrumentation*
Bone Diseases, Developmental / complications*
Femur / abnormalities, radiography, surgery*
Osteoarthritis, Hip / etiology, physiopathology, radiography, surgery*
Range of Motion, Articular
Recovery of Function
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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