Document Detail


Custom cementless THA in patients with skeletal dysplasia results in lower apparent revision rates than other types of femoral fixation.
MedLine Citation:
PMID:  21042892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mathew D Sewell; Sammy A Hanna; Sarah K Muirhead-Allwood; Stephen R Cannon; Timothy W R Briggs
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-11-02
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 May 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  1406-12     Citation Subset:  AIM; IM    
Affiliation:
Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. matbuzz1@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acetabulum / radiography,  surgery
Adolescent
Adult
Arthroplasty, Replacement, Hip / adverse effects,  instrumentation*
Bone Diseases, Developmental / complications*
Computer-Aided Design
England
Female
Femur / abnormalities,  radiography,  surgery*
Hip Prosthesis*
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Osteoarthritis, Hip / etiology,  physiopathology,  radiography,  surgery*
Prosthesis Design
Range of Motion, Articular
Recovery of Function
Reoperation
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
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