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Acetabular reconstruction in developmental hip dysplasia using reinforcement ring with a hook

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Abstract

We followed prospectively 27 patients with severe acetabular bone-stock deficiencies due to developmental dysplasia of the hip. Mean preoperative patient age was 56 (34–78) years, mean Harris hip score was 31 (16–66) points and pre-operative mean acetabular angle of Sharp was 47° (34°–61°). Operative acetabular reconstruction was performed in 28 hips using reinforcement ring with a hook placed in the true acetabulum and autologous bone grafting. A 2-year clinical and radiological follow-up was available in 27 hips. Mean Harris hip score improved to 91 (70–100) points. There were no clinical or radiological signs of aseptic loosening in 25 hips, and the bone graft was radiologically incorporated in all hips. In 24 hips, a radiostereometric analysis showed low rates of non-progressive translation and rotation in 21 reinforcement rings. Three rings showed progressive translation and/or rotation at the 2-year follow-up and were rated probably loose.

Résumé

Nous avons suivi 27 malades avec des déficiences acétabulaires sévères dû à une dysplasie de développement de la hanche. L’âge moyen préopératoire des malades était de 56 ans (34–78), le score moyen de Harris était de 31 points (16–66) et l’angle moyen de Sharp préopératoire était de 47° (34°–61°). La reconstruction acétabulaire a été exécutée dans 28 hanches en utilisent un anneau de renforcement avec crochet, placé dans le paléo-cotyle, avec greffe osseuse autologue. Un suivi clinique et radiologique de 2 années était disponible pour 27 hanches. Le score moyen de Harris a été amélioré à 91 points (70–100). Il n’y avait pas de signe clinique ou radiologique de descellement aseptique dans 25 hanches et la greffe osseuse était incorporée dans toutes les hanches. Dans 24 hanches une analyse radiostéréométrique a montré un faible taux de translation et de rotation, non progressive, de 21 anneaux de renforcement. Trois anneaux ont montré une translation et/ou une rotation progressive au cours du suivi de 2 années et ont été considérés comme descellés.

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Correspondence to Rocco P. Pitto.

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Pitto, R.P., Schikora, N. Acetabular reconstruction in developmental hip dysplasia using reinforcement ring with a hook. International Orthopaedics (SICOT) 28, 202–205 (2004). https://doi.org/10.1007/s00264-004-0559-9

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