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Total hip arthroplasty using S-ROM prosthesis for dysplastic hip.

Kang JS, Moon KH, Kim RS, Park SR, Lee JS, Shin SH - Yonsei Med. J. (2011)

Bottom Line: The average Harris hip score improved from 52.2 points to 88.5 points.All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth.Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Inha University College of Medicine, 7-206 Sinheung-dong 3-ga, Jung-gu, Incheon 400-711, Korea. kangjoon@inha.ac.kr

ABSTRACT

Purpose: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip.

Materials and methods: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis.

Results: The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up.

Conclusion: For advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria.

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Related in: MedlinePlus

(A) Radiography of a 38-year-old female patient shows Crowe's type IV dysplasia of the right hip. (B) Total hip arthroplasty with femoral shortening osteotomy was performed. The radiograph at five years post operation shows stable cup fixation in the true acetabulum.
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Figure 2: (A) Radiography of a 38-year-old female patient shows Crowe's type IV dysplasia of the right hip. (B) Total hip arthroplasty with femoral shortening osteotomy was performed. The radiograph at five years post operation shows stable cup fixation in the true acetabulum.

Mentions: In two cases, there were progressive radiolucent lines and loosening around the acetabular cup. Of these, one case underwent monitoring of the clinical course and the other case was diagnosed as the loosening of an infected cup. The latter case was treated with revision surgery. Excluding these two cases, the remaining 43 cases showed stable fixation. There were no findings that were suggestive of osteolysis of the acetabular cup. In all cases, the femoral stem showed stable fixation (Figs. 1 and 2). The initial degree of the femoral fixation was also measured in accordance with the classification system proposed by Engh and Bobyn.8 This showed that 41 cases had canal filling of >90% and four cases had canal filling ranging from 80% to 90%. These findings indicate that all cases had satisfactory canal filling. The stability of the femoral stem was assessed based on the classification system proposed by Engh, et al.9 This showed that 37 cases had bony stability and eight cases had fibrous stability. There were no cases of instability. Fibrous fixation was defined in the cases in which the reactive radiolucent line was observed in Gruen zones II and VI until postoperative year 2. Thereafter, the radiolucent line did not progress further, but rather was stabilized. In ten cases, a reactive radiolucent line was observed in Zone I around the femoral stem. Yet it was assumed that these lines were local reactive lines that did not extend to the areas below the sleeve. Upon final follow-up, radiolucency of the calca femorale was observed in 16 cases (35.5%). Progressive bone loss of the proximal femur due to stress shielding was not shown.


Total hip arthroplasty using S-ROM prosthesis for dysplastic hip.

Kang JS, Moon KH, Kim RS, Park SR, Lee JS, Shin SH - Yonsei Med. J. (2011)

(A) Radiography of a 38-year-old female patient shows Crowe's type IV dysplasia of the right hip. (B) Total hip arthroplasty with femoral shortening osteotomy was performed. The radiograph at five years post operation shows stable cup fixation in the true acetabulum.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104464&req=5

Figure 2: (A) Radiography of a 38-year-old female patient shows Crowe's type IV dysplasia of the right hip. (B) Total hip arthroplasty with femoral shortening osteotomy was performed. The radiograph at five years post operation shows stable cup fixation in the true acetabulum.
Mentions: In two cases, there were progressive radiolucent lines and loosening around the acetabular cup. Of these, one case underwent monitoring of the clinical course and the other case was diagnosed as the loosening of an infected cup. The latter case was treated with revision surgery. Excluding these two cases, the remaining 43 cases showed stable fixation. There were no findings that were suggestive of osteolysis of the acetabular cup. In all cases, the femoral stem showed stable fixation (Figs. 1 and 2). The initial degree of the femoral fixation was also measured in accordance with the classification system proposed by Engh and Bobyn.8 This showed that 41 cases had canal filling of >90% and four cases had canal filling ranging from 80% to 90%. These findings indicate that all cases had satisfactory canal filling. The stability of the femoral stem was assessed based on the classification system proposed by Engh, et al.9 This showed that 37 cases had bony stability and eight cases had fibrous stability. There were no cases of instability. Fibrous fixation was defined in the cases in which the reactive radiolucent line was observed in Gruen zones II and VI until postoperative year 2. Thereafter, the radiolucent line did not progress further, but rather was stabilized. In ten cases, a reactive radiolucent line was observed in Zone I around the femoral stem. Yet it was assumed that these lines were local reactive lines that did not extend to the areas below the sleeve. Upon final follow-up, radiolucency of the calca femorale was observed in 16 cases (35.5%). Progressive bone loss of the proximal femur due to stress shielding was not shown.

Bottom Line: The average Harris hip score improved from 52.2 points to 88.5 points.All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth.Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Inha University College of Medicine, 7-206 Sinheung-dong 3-ga, Jung-gu, Incheon 400-711, Korea. kangjoon@inha.ac.kr

ABSTRACT

Purpose: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip.

Materials and methods: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis.

Results: The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up.

Conclusion: For advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria.

Show MeSH
Related in: MedlinePlus