Cotyloplasty in cementless total hip arthroplasty for an insufficient acetabulum
Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) u...
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Published in | Clinics in orthopedic surgery Vol. 2; no. 3; pp. 148 - 153 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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Korea (South)
The Korean Orthopaedic Association
01.09.2010
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Abstract | Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of medial cup protrusion.
Sixteen hips with insufficient acetabulum in sixteen patients were treated by cementless THA using cotyloplasty. The average patient age was 47 years. The diagnoses included dysplastic hip (12) and infection sequelae (4). All the patients were followed up for at least 2 years. Clinically, the Harris hip scores were assessed and radiologically, the amount of cup protrusion, the hip center movement and cup fixation were evaluated.
The average Harris hip score improved from 57 to 94 postoperatively. The average proportion of cup surface beyond the Kohler line was 44.1% and the hip centers were medialized by an average of 23 mm. Stable fixation of the acetabular cup was achieved in all the cases except one. In this one case, migration of the cup was detected 2 weeks postoperatively and a reoperation was performed.
Using cotyloplasty, good coverage of the acetabular cup was obtained without a block bone graft, and the hip joint centers were medialized. However, the safety margin for the amount of protrusion should be established. |
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AbstractList | Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of medial cup protrusion.
Sixteen hips with insufficient acetabulum in sixteen patients were treated by cementless THA using cotyloplasty. The average patient age was 47 years. The diagnoses included dysplastic hip (12) and infection sequelae (4). All the patients were followed up for at least 2 years. Clinically, the Harris hip scores were assessed and radiologically, the amount of cup protrusion, the hip center movement and cup fixation were evaluated.
The average Harris hip score improved from 57 to 94 postoperatively. The average proportion of cup surface beyond the Kohler line was 44.1% and the hip centers were medialized by an average of 23 mm. Stable fixation of the acetabular cup was achieved in all the cases except one. In this one case, migration of the cup was detected 2 weeks postoperatively and a reoperation was performed.
Using cotyloplasty, good coverage of the acetabular cup was obtained without a block bone graft, and the hip joint centers were medialized. However, the safety margin for the amount of protrusion should be established. BACKGROUNDCotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of medial cup protrusion. METHODSSixteen hips with insufficient acetabulum in sixteen patients were treated by cementless THA using cotyloplasty. The average patient age was 47 years. The diagnoses included dysplastic hip (12) and infection sequelae (4). All the patients were followed up for at least 2 years. Clinically, the Harris hip scores were assessed and radiologically, the amount of cup protrusion, the hip center movement and cup fixation were evaluated. RESULTSThe average Harris hip score improved from 57 to 94 postoperatively. The average proportion of cup surface beyond the Kohler line was 44.1% and the hip centers were medialized by an average of 23 mm. Stable fixation of the acetabular cup was achieved in all the cases except one. In this one case, migration of the cup was detected 2 weeks postoperatively and a reoperation was performed. CONCLUSIONSUsing cotyloplasty, good coverage of the acetabular cup was obtained without a block bone graft, and the hip joint centers were medialized. However, the safety margin for the amount of protrusion should be established. |
Author | Yoo, Jeong Joon Nam, Kwang Woo Kim, Yong Lae Kim, Hee Joong Kim, Young-Min |
AuthorAffiliation | Department of Orthopaedic Surgery, Cheju National University College of Medicine, Cheju, Korea Department of Orthopaedic Surgery, Inchon Medical Center, Inchon, Korea Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea |
AuthorAffiliation_xml | – name: Department of Orthopaedic Surgery, Inchon Medical Center, Inchon, Korea – name: Department of Orthopaedic Surgery, Cheju National University College of Medicine, Cheju, Korea – name: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea |
Author_xml | – sequence: 1 givenname: Yong Lae surname: Kim fullname: Kim, Yong Lae organization: Department of Orthopaedic Surgery, Inchon Medical Center, Inchon, Korea – sequence: 2 givenname: Kwang Woo surname: Nam fullname: Nam, Kwang Woo – sequence: 3 givenname: Jeong Joon surname: Yoo fullname: Yoo, Jeong Joon – sequence: 4 givenname: Young-Min surname: Kim fullname: Kim, Young-Min – sequence: 5 givenname: Hee Joong surname: Kim fullname: Kim, Hee Joong |
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Cites_doi | 10.2106/00004623-197961010-00004 10.2106/00004623-197860020-00014 10.1302/0301-620X.72B1.2298795 10.1016/S0883-5403(99)90115-8 10.2106/00004623-197658060-00015 10.1016/S0883-5403(96)80164-1 10.2106/00004623-198870020-00004 10.1097/00003086-197303000-00015 10.2106/00004623-199605000-00007 10.2106/00004623-199072070-00011 10.1016/j.arth.2005.04.007 10.2106/00004623-200110000-00004 10.1016/S0883-5403(08)80077-0 10.2106/00004623-199901000-00012 10.1302/0301-620X.80B4.7361 10.2106/00004623-196951040-00012 |
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Keywords | Cementless Total hip replacement Hip dysplasia Insufficient acetbulum Cotyloplasty |
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Snippet | Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial... BACKGROUNDCotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with... |
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SubjectTerms | Acetabulum - diagnostic imaging Acetabulum - pathology Acetabulum - surgery Adult Arthritis, Infectious - complications Arthritis, Infectious - pathology Arthroplasty, Replacement, Hip Female Hip Dislocation, Congenital - pathology Hip Dislocation, Congenital - surgery Hip Joint - diagnostic imaging Hip Prosthesis Humans Male Middle Aged Original Radiography |
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Title | Cotyloplasty in cementless total hip arthroplasty for an insufficient acetabulum |
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