Minimum 10-year Survivorship of Uncemented Acetabular Reconstruction with Bulk Femoral Head Autografting in Crowe Type IV Developmental Hip Dysplasia

Masahiro Suzuki; Takeshi Masuda; Taiki Kanno; Masahiro Inoue; Satomi Abe; Takuaki Yamamoto

doi:10.1016/j.arth.2024.05.013

Minimum 10-year Survivorship of Uncemented Acetabular Reconstruction with Bulk Femoral Head Autografting in Crowe Type IV Developmental Hip Dysplasia

J Arthroplasty. 2024 May 10:S0883-5403(24)00446-7. doi: 10.1016/j.arth.2024.05.013. Online ahead of print.

Authors

Masahiro Suzuki¹, Takeshi Masuda², Taiki Kanno², Masahiro Inoue², Satomi Abe², Takuaki Yamamoto³

Affiliations

¹ Department of Orthopedic Surgery, Eniwa Hospital, Eniwa, Hokkaido, Japan; Department of Orthopedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan. Electronic address: 0321suzuki@gmail.com.
² Department of Orthopedic Surgery, Eniwa Hospital, Eniwa, Hokkaido, Japan.
³ Department of Orthopedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.

PMID: 38735553
DOI: 10.1016/j.arth.2024.05.013

Abstract

Background: In total hip arthroplasty (THA) for severe dislocations such as Crowe type IV developmental dysplasia of the hip (DDH), sufficient bone volume for stable fixation of the acetabular component can be achieved by placing a reinforcing bone graft prepared from the resected femoral head into the deficient acetabulum. The purpose of the current study was to examine the long-term survivorship of uncemented THA in conjunction with a bulk femoral head autograft in patients who have Crowe type IV DDH.

Methods: A total of 35 patients (42 hips) who have Crowe type IV DDH and underwent THA using uncemented cup fixation with bulk femoral head autografting were followed up for a mean period of 15.0 years (range, 10.0 to 20.0) postoperatively. Anteroposterior pelvic radiographs were used for measurements such as the horizontal coverage of the grafted bone and the center-edge angle. Kaplan-Meier survivorship analyses were performed with revision of the acetabular component as the endpoint.

Results: The Kaplan-Meier analysis indicated 15-year survival rates of 90.4%. The mean horizontal coverage of grafted bone was 46.1% (range, 23.7 to 66.0), and there were 16 cases with horizontal coverage of ≥ 50%. There was no difference in the appearance of a thin (< 1 mm) radiolucency line around the cup between cases with < 50% versus ≥ 50% of the horizontal coverage of grafted bone (4 versus 2 hips; P = 0.446). Trabecular bridging and remodeling were seen in all cases after mean periods of 4.1 months and 9.0 months postoperatively, respectively. Trabecular reorientation was seen in 41 of 42 hips (97.6%) at a mean follow-up of 19.9 months.

Conclusions: Acetabular reconstruction with femoral bulk bone grafting for Crowe type IV DDH resulted in high survival rates and was a good method to restore bone stock and obtain long-term fixation.