Abstract
Purpose
The purpose of this study was to review retrospectively the cases operated upon in our department in recent years with a Wagner stem and a small socket in cases of Crowe I or II dysplastic hips.
Methods
We conducted a retrospective clinical radiological review of 30 hips diagnosed with hip dysplasia Crowe I or II treated in our centre between 2002 and 2008. All of them were treated with a Wagner cone stem and a small Trilogy acetabulum (Zimmer ®).
Results
There were 15 men and 11 women with 13 left and 17 right femurs. Mean follow-up was 43.44 months (range 14–87). Eight patients were Crowe I type and 22 were Crowe II type. Merlé d'Aubigne score pre-operatively was 12.23 and at the last follow-up was 15.54. Mean leg length inequality was 1.79 and after surgery it was 0.69 cm. Complications included three infection and three dislocations (two of them in the same patient).
Conclusions
The use of a Wagner stem is a good option to correct the different deformities in the proximal femur in these cases. A small socket allows a correct relocation of the acetabulum in a dysplastic socket with good bone coverage.
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References
Sugano N, Noble PC, Kamaric E, Salama JK, Ochi T, Tullos HS (1998) The morphology of the femur in developmental dysplasia of the hip. J Bone Joint Surg Br 80:711–719
Dezateux C, Rosendahl K (2007) Developmental dysplasia of the hip. Lancet 369(9572):1541–1552
Flecher X, Parratte S, Brassart N, Aubaniac JM, Argenson JN (2008) Evaluation of the hip center in total hip arthroplasty for old developmental dysplasia. J Arthroplasty 23(8):1189–1196
Jacobsen S (2006) Adult hip dysplasia and osteoarthritis. Studies in radiology and clinical epidemiology. Acta Orthop Suppl 77(324):1–37
Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg 61:15–23
Bicanic G, Delimar D, Delimar M, Pecina M (2009) Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop 33:397–402
Merle d’Aubigné R, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36-A:451–475
Papachristou G, Hatzigrigoris P, Panousis K, Plessas S, Sourlas J, Levidiotis C, Chronopoulos E (2006) Total hip arthroplasty for developmental hip dysplasia. Int Orthop 30:21–25
McBryde CW, Shears E, O’Hara JN, Pynsent PB (2008) Metal-on-metal hip resurfacing in developmental dysplasia. J Bone Joint Surg Br 90-B:708–714
Amstutz HC, Le Duff MJ, Harvey N, Hoberg M (2008) Improved survivorship of hybrid metal-on-metal hip resurfacing with second-generation techniques for Crowe-I and II developmental dysplasia of the hip. J Bone Joint Surg 90:12–20
Ström H, Mallmin H, Milbrink J, Petrén-Mallmin M, Nivbrant B, Kolstad K (2003) The coned hip item: a prospective study of 13 patients followed for 5 years with RSA. Acta Orthop Scand 74(5):525–530
Pak P, de Steiger R (2008) Cone femoral prosthesis for osteoarthritis of the hip femoral dysplasia. J Orthop Surg 16(2):206–210
Ito H, Tanino H, Yamanaka Y, Nakamura T, Matsuno T (2010) Hybrid total hip arthroplasty using specifically-designed items for patients with developmental dysplasia of the hip. A minimum five-year follow-up study. Int Orthop Jul 24 [Epub ahead to print]
Kendrick JB 2nd, Noble PC, Tullos HS (1995) Distal stem design and the torsional stability of cementless femoral stems. J Arthroplasty 10(4):464–469
Böhm P, Bischel O (2004) The use of tapered stems form femoral revision surgery. Clin Orthop Relat Res 420:148–159
Kobayashi A, Donnelly WJ, Scott G, Freeman MA (1997) Early radiological observations may predict the long-term survival of femoral hip prostheses. J Bone Joint Surg Br 79:583–589
Freeman MA, Plante-Bordeneuve P (1994) Early migration and late aseptic failure of proximal femoral prostheses. J Bone Joint Surg Br 76:432–438
Schuh A, Schrami A, Hohenberger G (2008) Long-term results of the Wagner conical screws cup. Int Orthop 33(3):659–664
Bruzzone M, La Russa M, Garzaro G, Ferro A, Rossi P, Castoldi F, Rossi R (2009) Long-term results of cementless anatomic total hip replacement in dysplastic hips. Chir Organi Mov 93(3):131–136
Baker PN, Mc Murtry IA, Chuter G, Port A, Anderson J (2010) THA with the ABG I Prosthesis at 15 years: excellent survival with minimal osteolysis. Clin Orthop Relat Res 468(7):1855–1861
Spangehl MJ, Berry BJ, Trousdale T, Cabanela ME (2001) Uncemented acetabular componentes with bulk femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: results at five to twelve years. J Bone Joint Surg 83:1484–1489
Delimar D, Cicak N, Klobucar H, Pecina M, Korzinek K (2002) Acetabular roof reconstruction with pedicled iliac graft. Int Orthop 26(6):344–348
Rozkydal Z, Janícek P, Smíd Z (2005) Total hip replacement with the CLS expansion shell and a structural femoral head autograft for patients with congenital hip disease. J Bone Joint Surg 87:801–807
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Torres Claramunt, R., Marqués, F., León, A. et al. Total hip replacement with an uncemented Wagner cone stem for patients with congenital hip dysplasia. International Orthopaedics (SICOT) 35, 1767–1770 (2011). https://doi.org/10.1007/s00264-011-1218-6
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DOI: https://doi.org/10.1007/s00264-011-1218-6