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

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Hip Arthroplasty

Background:

• Developmental dysplasia of the hip often leads to severe acetabular bone-stock deficiencies.
• Reconstructing these deficiencies is challenging and crucial for successful hip arthroplasty.
• Existing reconstruction methods may have limitations in addressing significant bone loss.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of acetabular reconstruction using reinforcement rings with autologous bone grafting.
• To assess the rate of aseptic loosening and bone graft incorporation.
• To analyze the stability of reinforcement rings using radiostereometric analysis.

Main Methods:

• Prospective follow-up of 27 patients (28 hips) with severe acetabular bone-stock deficiencies.
• Surgical technique involved reinforcement ring with hook and autologous bone grafting.
• Clinical assessment using Harris hip score and radiological evaluation including radiostereometric analysis at 2-year follow-up.

Main Results:

• Significant improvement in mean Harris hip score from 31 to 91 points.
• No aseptic loosening in 25 out of 27 hips; bone graft incorporation in all hips.
• Radiostereometric analysis showed low rates of non-progressive translation/rotation in 21 out of 24 rings; 3 rings were probably loose.

Conclusions:

• Reinforcement ring with autologous bone grafting is an effective method for acetabular reconstruction in severe bone-stock deficiencies.
• The procedure leads to significant functional improvement and good graft incorporation.
• While generally stable, careful monitoring for potential implant loosening is warranted.