Does total hip arthroplasty with high hip centre in dysplasia compromise acetabular bone stock?

Background: The placement of uncemented acetabular components during total hip arthroplasty (THA) in Crowe II and Crowe III dysplasia can be at the anatomic or high hip centre position. Purposes: Using computerised tomography data, we simulated acetabular cup placement at the anatomic hip centre and...

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Publicado en:Hip International Vol. 33; no. 3; pp. 518 - 525
Autores principales: Kannan, Arun, Madurawe, Chameka, Pierrepont, Jim, McMahon, Stephen
Formato: diagnostic images research tables/charts Journal Article
Publicado: Sage Publications Inc. May2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2023
      vid: 33
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/11207000211059442
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        atl: Does total hip arthroplasty with high hip centre in dysplasia compromise acetabular bone stock?
      aug:
        au:
          Kannan, Arun
          Madurawe, Chameka
          Pierrepont, Jim
          McMahon, Stephen
        affil: Apollo Main Hospital, Chennai, Tamilnadu, India
      sug:
        subj:
          Arthroplasty, Replacement, Hip
          Surgery, Reconstructive Methods
          Cell Transformation, Neoplastic
          Joint Prosthesis
          Acetabulum
          Human
          Prospective Studies
          Image Processing, Computer Assisted
          Comparative Studies
          Descriptive Statistics
          Bone Substitutes
          Young Adult
          Models, Anatomic
      ab: Background: The placement of uncemented acetabular components during total hip arthroplasty (THA) in Crowe II and Crowe III dysplasia can be at the anatomic or high hip centre position. Purposes: Using computerised tomography data, we simulated acetabular cup placement at the anatomic hip centre and the high hip centre positions to assess whether there is a difference between the 2 in terms of bone loss from acetabular reaming and in acetabular coverage by host bone. Methods: The study population included a consecutive cohort of 19 patients (22 hips) with Crowe II or III dysplasia. 3-dimensional models of the pelvis were created for each patient and digital templating was used to determine the anatomic and high hip centre positions. The coordinates of the digitally templated cup positions were fed into an image processing software to estimate the amount of bone reamed, the cup coverage by host bone and the elevation from tear drop. Results: The mean volume of bone reamed was greater in the high hip centre position as compared to the anatomic position (27.3 ± 11. 4 cm3 vs. 19.4 ± 12.2 cm3, p < 0.0001). The coverage of the acetabular cup by host bone was greater in the high hip centre position (87.3 ± 5.9% vs. 68.3 ± 10%). The mean elevation in the high hip centre group was 13 mm with 3 hips having a breach of the medial wall. Conclusions: In Crowe II and III dysplasia, placement of acetabular cups at the anatomic hip centre better preserves bone stock as compared to high hip centre placement and should be preferred in young patients requiring THA.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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