دورية أكاديمية
أعرض في EDS

Long-term results of total hip arthroplasty in severe congenital hip disease: A ten- to 20-year follow-up study.

التفاصيل البيبلوغرافية
العنوان: Long-term results of total hip arthroplasty in severe congenital hip disease: A ten- to 20-year follow-up study.
المؤلفون: Garcia-Rey E; Hôpital Universitario La Paz-Idi Paz, P Castellana 261, Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, P° Castellana 261, 28046 Madrid, Spain. Electronic address: edugrey@yahoo.es., Saldaña L; Hôpital Universitario La Paz-Idi Paz, P Castellana 261, Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, P° Castellana 261, 28046 Madrid, Spain.
المصدر: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2024 Oct; Vol. 110 (6), pp. 103850. Date of Electronic Publication: 2024 Feb 29.
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: Elsevier Masson SAS Country of Publication: France NLM ID: 101494830 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1877-0568 (Electronic) Linking ISSN: 18770568 NLM ISO Abbreviation: Orthop Traumatol Surg Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Issy les Moulineaus, France : Elsevier Masson SAS,
مواضيع طبية MeSH: Arthroplasty, Replacement, Hip*/methods , Reoperation*/statistics & numerical data , Hip Dislocation, Congenital*/surgery , Hip Dislocation, Congenital*/diagnostic imaging, Humans ; Female ; Male ; Follow-Up Studies ; Middle Aged ; Adult ; Treatment Outcome ; Retrospective Studies ; Time Factors ; Osteoarthritis, Hip/surgery ; Osteoarthritis, Hip/etiology ; Postoperative Complications/epidemiology ; Young Adult ; Aged ; Patient Satisfaction ; Risk Factors
مستخلص: Introduction: The impact of bone deformities, previous surgeries, and the surgical technique in total hip arthroplasty (THA) for congenital dislocation of the hip (CDH) at a long-term has not been clearly defined yet. In this single-centre observational study we sought to assess patients undergoing THA due to osteoarthritis secondary to severe CDH with low or high dislocation ten- to 20-years after surgery. To determine this purpose, we assessed: (1) THA-related complications and reoperations; (2) the clinical outcome, patients' satisfaction and radiological results; and (3) the possible risk factors for reoperation with particular attention to the surgical technique and the influence of prior surgeries.
Hypothesis: We hypothesized that an anatomical reconstruction of the hip would decrease the reoperations rates in patients undergoing THA with severe CDH.
Methods: Seventy-five patients (85 hips) operated between 1999 and 2012 at our large tertiary hospital were analyzed. Fifty-six hips were diagnosed as low dislocation (group 1) and 29 hips as high dislocation (group 2). The existence of prior surgeries was frequent: group 1, pelvic osteotomies 6 hips, femoral osteotomies 7, tectoplasty (shelf) 6, resection arthroplasty 1 and lowering of the greater trochanter 1; group 2 included pelvic osteotomies 10 hips, femoral osteotomies 10, and a femoral lengthening 2. The number of additional procedures during THA was: group 1 (19/56 [34%]), acetabular roof bone autograft 8 hips, acetabular medial wall autograft 2, hardware removal 6, extended femoral osteotomy 2, and a femoral shortening 1; group 2 (20/29 [69%]), acetabular bone autograft 12 hips, medial autograft 1, hardware removal 1, extended femoral osteotomy 2, and a femoral shortening 4 hips. The clinical and the radiological analysis were compared in both groups for a minimum follow-up of ten years. Cox regression models were used to detect risk factors for reoperation.
Results: Nine patients (13.8%) required reoperation for the following reasons: cup loosening (5 hips), periprosthetic femoral fracture (3) and stem loosening (1); seven had prior surgeries. The 12-year survival rate for reoperation for any reason was 96.3% (95% confidence interval [CI] 91.2-100) in group 1 and 75.7% (95% CI, 65.8-90.8) in group 2 (p=0.003). Patients with high dislocation (p=0.02, hazard ratio [HR]: 6.25, 95% CI, 1.26-30.9) and those with an acetabular component inclination placed out of the target zone between 35° and 50° (p=0.03, HR: 4.27, 95% CI, 1.13-16.1) had a higher risk of reoperation.
Discussion: An optimal placement of the acetabular component decreased the reoperation rates in patients undergoing THA for severe CDH. Hips with high dislocation and the existence of prior surgery can affect THA implantation.
Level of Evidence: III; retrospective; comparative.
(Copyright © 2024. Published by Elsevier Masson SAS.)
فهرسة مساهمة: Keywords: Clinical outcome; Congenital hip disease; Radiological analysis; Total hip arthroplasty
تواريخ الأحداث: Date Created: 20240301 Date Completed: 20240924 Latest Revision: 20240924
رمز التحديث: 20240925
DOI: 10.1016/j.otsr.2024.103850
PMID: 38428484
قاعدة البيانات: MEDLINE
الوصف
تدمد:1877-0568
DOI:10.1016/j.otsr.2024.103850