Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

Document Type : CURRENT CONCEPTS REVIEW

Authors

1 1st Department of Orthopaedics, Athens University Medical School, ATTIKON University General Hospital

2 1st Department of Orthopaedics, Athens University Medical School, ATTIKON University General Hospital, Chaidari, Greece

3 2nd Orthopaedic Department University of Athens Medical School Konstantopouleio General Hospital Nea Ionia, Athens

Abstract

Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging.
Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH) differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

Keywords

References

  1. Engesaeter IO, Lehmann T, Laborie LB, Lie SA, Rosendahl K, Engesaeter LB. Total hip replacement in young adults with hip dysplasia: age at diagnosis, previous treatment, quality of life, and validation of diagnoses reported to the Norwegian Arthroplasty Register between 1987 and 2007. Acta Orthop. 2011; 82(2): 149-54.

  2. Karachalios T, Hartofilakidis G. Congenital hip disease in adults: terminology, classification, pre-operative planning and management. J Bone Joint Surg Br. 2010;92(7):914-21.

  3. Merle D’Aubigne RM. Reposition with arthroplasty for congenital dislocation of the hip in adults. J Bone Joint Surg Br. 1952;34(1):22-9.

  4. Argenson JN, Flecher X, Parratte S, Aubaniac JM. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res. 2007; 465:40-5.

  5. Albinana J, Dolan LA, Spratt KF, Morcuende J, Meyer MD, Weinstein SL. Acetabular dysplasia after treatment for developmental dysplasia of the hip. Implications for secondary procedures. J Bone Joint Surg Br. 2004; 86(6):876-86.

  6. Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N. Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am. 1996; 78(5):683-92.

  7. Lai KA, Lin CJ, Jou IM, Su FC. Gait analysis after total hip arthroplasty with leg-length equalization in women with unilateral congenital complete dislocation of the hip--comparison with untreated patients. J Orthop Res. 2001; 19(6):1147-52.

  8. Radin EL, Paul IL. The biomechanics of congenital dislocated hips and their treatment. Clin Orthop Relat Res. 1974; (98):32-8.

  9. Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979; 61(1):15-23.

  10. Hartofilakidis G, Babis GC, Lampropoulou-Adamidou K, Vlamis J. Results of Total Hip Arthroplasty Differ in Subtypes of High Dislocation. Clin Orthop Relat Res. 2013; 471(9):2972-9.

  11. Brunner A, Ulmar B, Reichel H, Decking R. The Eftekhar and Kerboul classifications in assessment of developmental dysplasia of the hip in adult patients. Measurement of inter- and intraobserver reliability. HSS J. 2008; 4(1):25-31.

  12. Anderson MJ, Harris WH. Total hip arthroplasty with insertion of the acetabular component without cement in hips with total congenital dislocation or marked congenital dysplasia. J Bone Joint Surg Am. 1999; 81(3):347-54.

  13. Decking R, Brunner A, Decking J, Puhl W, Gunther KP. Reliability of the Crowe und Hartofilakidis classifications used in the assessment of the adult dysplastic hip. Skeletal Radiol. 2006; 35(5):282-7.

  14. Kose O, Celiktas M, Guler F, Baz AB, Togrul E, Akalin S. Inter- and intraobserver reliability of the Crowe and Hartofilakidis classifications in the assessment of developmental dysplasia of the hip in adult patients. Arch Orthop Trauma Surg. 2012; 132(11):1625-30.

  15. Gaston MS, Gaston P, Donaldson P, Howie CR. A new classification system for the adult dysplastic hip requiring total hip arthroplasty: a reliability study. Hip Int. 2009;19(2):96-101.

  16. Yiannakopoulos CK, Chougle A, Eskelinen A, Hodgkinson JP, Hartofilakidis G. Inter- and intra-observer variability of the Crowe and Hartofilakidis classification systems for congenital hip disease in adults. J Bone Joint Surg Br. 2008; 90(5):579-83.

  17. Yiannakopoulos CK, Xenakis T, Karachalios T, Babis GC, Hartofilakidis G. Reliability and validity of the Hartofilakidis classification system of congenital hip disease in adults. Int Orthop. 2009; 33(2):353-8.

  18. Werner CM, Copeland CE, Ruckstuhl T, Stromberg J, Turen CH, Bouaicha S. Relationship between Wiberg’s lateral center edge angle, Lequesne’s acetabular index, and medial acetabular bone stock. Skeletal Radiol. 2011; 40(11):1435-9.

  19. Werner CM, Ramseier LE, Ruckstuhl T, Stromberg J, Copeland CE, Turen CH, et al. Normal values of Wiberg’s lateral center-edge angle and Lequesne’s acetabular index--a coxometric update.Skeletal Radiol. 2012;41(10):1273-8.

  20. Stans AA, Pagnano MW, Shaughnessy WJ, Hanssen AD. Results of total hip arthroplasty for Crowe Type III developmental hip dysplasia. Clin Orthop Relat Res. 1998; 348:149-57.

  21. Charnley J, Feagin JA. Low-friction arthroplasty in congenital subluxation of the hip. Clin Orthop Relat Res. 1973;(91):98-113.

  22. Garvin KL, Bowen MK, Salvati EA, Ranawat CS. Long-term results of total hip arthroplasty in congenital dislocation and dysplasia of the hip. A follow-up note. J Bone Joint Surg Am. 1991; 73(9):1348-54.

  23. Macheras GA, Kateros K, Koutsostathis SD, Tsakotos G, Galanakos S, Papadakis SA. The Trabecular Metal Monoblock acetabular component in patients with high congenital hip dislocation: a prospective study. J Bone Joint Surg Br. 2010; 92(5):624-8.

  24. Takigami I, Ito Y, Matsumoto K, Ogawa H, Terabayashi N, Shimizu K. Primary total hip arthroplasty with a spongy metal surface acetabular component for hip dysplasia. J Arthroplasty. 2013; 28(1):172-7.

  25. Kim YH, Park JW, Kim JS. Cementless metaphyseal fitting anatomic total hip arthroplasty with a ceramic-on-ceramic bearing in patients thirty years of age or younger. J Bone Joint Surg Am. 2012;94(17):1570-5.

  26. Pignatti G, Stagni C, Fravisini M, Giunti A. Ceramic-ceramic coupling. Total hip arthroplasty in young patients. Chir Organi Mov. 2003; 88(4):369-75.

  27. Numair J, Joshi AB, Murphy JC, Porter ML, Hardinge K. Total hip arthroplasty for congenital dysplasia or dislocation of the hip. Survivorship analysis and long-term results. J Bone Joint Surg Am. 1997; 79(9):1352-60.

  28. Sochart DH, Porter ML. Long-term results of cemented Charnley low-friction arthroplasty in patients aged less than 30 years. J Arthroplasty. 1998; 13(2):123-31.

  29. Holzapfel BM, Greimel F, Prodinger PM, Pilge H, Noth U, Gollwitzer H, et al. Total hip replacement in developmental dysplasia using an oval-shaped cementless press-fit cup. Int Orthop. 2012; 36(7): 1355-61.

  30. Schollner C, Decking J, Eckardt A. The Artek cup for total hip replacement of dysplastic hip joints. Arch Orthop Trauma Surg. 2003; 123(6):299-304.

  31. Zahos K, Mehendale S, Ward AJ, Smith EJ, Nichols M. The 15 degrees face-changing acetabular component for treatment of osteoarthritis secondary to developmental dysplasia of the hip. J Bone Joint Surg Br. 2012; 94(2):163-6.

  32. Gill TJ, Sledge JB, Muller ME. Total hip arthroplasty with use of an acetabular reinforcement ring in patients who have congenital dysplasia of the hip. Results at five to fifteen years. J Bone Joint Surg Am. 1998; 80(7):969-79.

  33. Siebenrock KA, Tannast M, Kim S, Morgenstern W, Ganz R. Acetabular reconstruction using a roof reinforcement ring with hook for total hip arthroplasty in developmental dysplasia of the hip-osteoarthritis minimum 10-year follow-up results. J Arthroplasty. 2005; 20(4):492-8.

  34. Koulouvaris P, Stafylas K, Xenakis T. Cementless modular centroid reconstruction cup in young adults with congenital dysplasia of the hip. J Arthroplasty. 2008; 23(1):79-85.

  35. Merle C, Grammatopoulos G, Waldstein W, Pegg E, Pandit H, Aldinger PR, et al. Comparison of native anatomy with recommended safe component orientation in total hip arthroplasty for primary osteoarthritis. J Bone Joint Surg Am. 2013; 95(22):172.

  36. Widmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion. J Orthop Res. 2004; 22(4):815-21.

  37. Dorr LD, Jones RE, Padgett DE, Pagnano M, Ranawat AS, Trousdale RT. Robotic guidance in total hip arthroplasty: the shape of things to come. Orthopedics. 2011; 34(9):652-5.

  38. Dorr LD, Malik A, Dastane M, Wan Z. Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res. 2009;467(1):119-27.

  39. Wasielewski RC, Galat DD, Sheridan KC, Rubash HE. Acetabular anatomy and transacetabular screw fixation at the high hip center. Clin Orthop Relat Res. 2005; 438:171-6.

  40. Liu Q, Zhou YX, Xu HJ, Tang J, Guo SJ, Tang QH. Safe zone for transacetabular screw fixation in prosthetic acetabular reconstruction of high developmental dysplasia of the hip. J Bone Joint Surg Am. 2009; 91(12): 2880-5.

  41. Boyle MJ, Frampton CM, Crawford HA. Early results of total hip arthroplasty in patients with developmental dysplasia of the hip compared with patients with osteoarthritis. J Arthroplasty. 2012; 27(3):386-90.

  42. Prokopetz JJ, Losina E, Bliss RL, Wright J, Baron JA, Katz JN. Risk factors for revision of primary total hip arthroplasty: a systematic review. BMC Musculoskelet Disord. 2012;13:251.

  43. Wright EA1, Katz JN, Baron JA, Wright RJ, Malchau H, Mahomed N, et al. Risk factors for revision of primary total hip replacement: results from a national case-control study. Arthritis Care Res (Hoboken). 2012; 64(12):1879-85.

  44. Dudkiewicz I, Salai M, Ganel A, Blankstein A, Chechik A. Total hip arthroplasty in patients younger than 30 years of age following developmental dysplasia of hip (DDH) in infancy. Arch Orthop Trauma Surg. 2002; 122(3):139-42.

  45. Eggli S, Hankemayer S, Muller ME. Nerve palsy after leg lengthening in total replacement arthroplasty for developmental dysplasia of the hip. J Bone Joint Surg Br. 1999; 81(5):843-5.

  46. Farrell CM, Springer BD, Haidukewych GJ, Morrey BF. Motor nerve palsy following primary total hip arthroplasty. J Bone Joint Surg Am. 2005; 87(12):2619-25.

  47. Georgiades G, Babis GC, Kourlaba G, Hartofilakidis G. Effect of cementless acetabular component orientation, position, and containment in total hip arthroplasty for congenital hip disease. J Arthroplasty. 2010; 25(7):1143-50.

  48. Kim M, Kadowaki T. High long-term survival of bulk femoral head autograft for acetabular reconstruction in cementless THA for developmental hip dysplasia. Clin Orthop Relat Res. 2010; 468(6):1611-20.

  49. Li H, Wang L, Dai K, Zhu Z. Autogenous impaction grafting in total hip arthroplasty with developmental dysplasia of the hip. J Arthroplasty. 2013; 28(4):637-43.

  50. Symeonides PP, Pournaras J, Petsatodes G, Christoforides J, Hatzokos I, Pantazis E. Total hip arthroplasty in neglected congenital dislocation of the hip. Clin Orthop Relat Res. 1997; 341:55-61.

  51. Bicanic G, Delimar D, Delimar M, Pecina M. Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop. 2009; 33(2): 397-402.

The Archives of Bone and Joint Surgery
Volume 2, Issue 3 - Serial Number 3
September 2014
Pages 130-136

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History

  • Receive Date: 28 June 2014
  • Revise Date: 23 July 2014
  • Accept Date: 04 August 2014

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