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Archives of Orthopaedic and Trauma Surgery

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01-05-2019 | Osteoarthrosis | Hip Arthroplasty

Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty

Authors: Yusuke Osawa, Taisuke Seki, Yasuhiko Takegami, Taiki Kusano, Naoki Ishiguro, Yukiharu Hasegawa

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2019

Abstract

Background

Acetabular wall defects after periacetabular osteotomy (PAO) lead to technical difficulties when performing subsequent total hip arthroplasty (THA). There is no unified consensus regarding the solution for THA socket installation after PAO. In the current study, we performed computed tomography (CT)-based simulation of socket installation and evaluated the acetabular defect following THA after PAO and after primary osteoarthritis (OA).

Patients and methods

The study group comprised 55 patients (56 hips) who underwent THA after PAO. For the control group, after matching for age, sex, and Crowe classification, we included 55 patients (56 hips) who underwent primary THA for hip dysplasia. We evaluated the anterior, posterior, and superior acetabular sector angle (ASA) and medial wall thickness (MWT) at the anatomical hip center (at the 20-mm vertical hip level from teardrop) in the study group (anatomical PAO group) and control group (primary OA group). In addition, we investigated the changes in the socket covering when the socket was positioned 10 mm above the anatomical hip center (30 mm above the teardrop; elevated osteotomy group).

Results

All ASA and MWT values were significantly smaller in the anatomical PAO group than in the primary OA group. In particular, the individuals with a Crowe classification of II/III in the anatomical PAO group presented severe acetabular defects. However, the elevated PAO group had a significantly larger ASA compared to the anatomical PAO group, with improved socket coverings.

Conclusion

Acetabular defects in the anatomical hip center following THA after PAO were significantly common compared to those after primary THA. Elevation of hip joint centers as much as 10 mm is one therapeutic option in the case of severe acetabular defects following THA after PAO.

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Title: Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty
Authors: Yusuke Osawa
Taisuke Seki
Yasuhiko Takegami
Taiki Kusano
Naoki Ishiguro
Yukiharu Hasegawa
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Computed Tomography
Computed Tomography
Osteoarthrosis
Hip-TEP
Hip-TEP
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03174-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty

Abstract

Background

Patients and methods

Results

Conclusion

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Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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