Cementless Total Hip Arthroplasty With a High Hip Center for Hartofilakidis Type B Developmental Dysplasia of the Hip: Results of Midterm Follow-Up

• Published in: The Journal of arthroplasty Vol. 31; no. 5; pp. 1027 - 1034
• Main Authors: Chen, Min, MD, Luo, Zheng-Liang, MD, Wu, Ke-Rong, MD, Zhang, Xiao-Qi, MD, Ling, Xiao-Dong, MD, Shang, Xi-Fu, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - surgery; Adult; Aged; Arthroplasty, Replacement, Hip - methods; Bone Cements; cementless; Female; Follow-Up Studies; Hartofilakidis type B; high hip center; Hip Dislocation, Congenital - diagnostic imaging; Hip Dislocation, Congenital - physiopathology; Hip Dislocation, Congenital - surgery; hip dysplasia; Hip Joint - diagnostic imaging; Hip Joint - surgery; Hip Prosthesis; Humans; Male; Middle Aged; Orthopedics; Prosthesis Failure; Recovery of Function; Retrospective Studies; total hip arthroplasty; Treatment Outcome; total hip arthroplasty; Hartofilakidis type B; hip dysplasia; high hip center; cementless
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2015.11.009

Abstract Background Acetabular reconstruction in adults with Hartofilakidis type B developmental dysplasia of the hip is a major technical challenge. The purpose of this retrospective study was to evaluate hip function and radiographic outcomes regarding high hip center at midterm follow-up. Methods From January 1, 2007 to December 31, 2009, 37 patients who had Hartofilakidis type B developmental dysplasia of the hip underwent a primary total hip arthroplasty using a high hip center technique. Functional, radiographic, and survivorship outcomes were evaluated. Results Of the 37 patients, 31 patients (83.8%) were available for the mean follow-up of 6.1 years (range, 1.5-7.6 years). Thirty-one cementless cups were located at an average vertical distance of 38.1 ± 3.3 mm and at a mean horizontal distance of 35.5 ± 3.4 mm. The mean ratio of the height of the hip center was 2.4% (range, 2.0%-2.9%). The Harris Hip Scores were improved from 50.3 points (range, 38-63 points) preoperatively to 92.3 points (range, 85-100 points) at the final follow-up ( P < .001). Four patients continued to present with Trendelenburg gait pattern at the last follow-up. With use of revision for any reason and aseptic loosening as the end point, the 5-year survival rates were 90.3% (95% CI, 79.9%-100%) and 93.3% (95% CI, 84.3%-100%), respectively. Conclusions The high hip center technique in conjunction with a cementless acetabular component seems to be a valuable alternative to achieve satisfactory midterm outcomes for Hartofilakidis type B developmental dysplasia of the hip.