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Surgical Technique of the 3-Dimensional-printed Personalized Hip Implant for the Treatment of Canine Hip Dysplasia
Published on: April 19, 2024
Cementless acetabular reconstruction and structural bone-grafting in dysplastic hips. Surgical technique
C Hendrich1, F Engelmaier, I Mehling
1Department of Orthopaedics, Würzburg University, Germany. christian.hendrich@kh-schloss-werneck.de
The Journal of Bone and Joint Surgery. American Volume
|March 3, 2007
Summary
This study found that cementless acetabular cups combined with bulk bone grafts offer satisfactory eleven-year survival rates for hip dysplasia patients. However, implant migration significantly impacts long-term success, increasing revision risk.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Radiology
Background:
- Acetabular reconstruction with cement and bulk bone graft shows increasing cup failure in dysplastic hips post-total hip arthroplasty.
- Limited long-term data exists for cementless implants combined with bulk bone grafting.
- This study aimed to evaluate clinical and radiographic outcomes of autologous bulk bone-grafting with cementless cups.
Purpose of the Study:
- To assess the long-term clinical and radiographic results of using autologous bulk bone-grafting in conjunction with cementless acetabular cups for developmental dysplasia of the hip.
- To determine the survival rates and identify factors influencing the success of these reconstructions.
Main Methods:
- Prospective follow-up of 47 patients (56 total hip arthroplasties) with developmental dysplasia of the hip from 1987-1992.
- Use of structural autologous bulk bone graft combined with cementless Harris-Galante type-I cups.
- Radiographic analysis of implant migration in 55 hips over an average of 10.2 years.
Main Results:
- Eleven-year survival rates were 91.6% (revision) and 88.9% (loosening).
- Cups with no migration had a 100% eleven-year survival rate, while migrated cups had a 69.3% survival rate (p=0.0012).
- Four implants were revised, and two showed radiographic loosening among surviving patients.
Conclusions:
- Cementless spherical press-fit cups with bulk bone-grafting demonstrate satisfactory eleven-year survival for complex acetabular reconstructions.
- Significant difference in survival between migrated and non-migrated implants highlights migration as a critical factor.
- Thirteen implants with progressive migration are at risk for future loosening, potentially increasing the revision rate.
