Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip
Objective The reconstruction of acetabular bone defect in developmental dysplasia of the hip (DDH) is a great challenge. Although several successful solutions have been raised, their efficacy and reliability have not been fully substantiated. This work aims to present a simple, economic and effectiv...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-04-01
|
| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13688 |
| _version_ | 1797847285274509312 |
|---|---|
| author | Zhonghua Xu Ziqiang Li Jie Li Yiling Zhang Min Wang Yuan Zhang |
| author_facet | Zhonghua Xu Ziqiang Li Jie Li Yiling Zhang Min Wang Yuan Zhang |
| author_sort | Zhonghua Xu |
| collection | DOAJ |
| description | Objective The reconstruction of acetabular bone defect in developmental dysplasia of the hip (DDH) is a great challenge. Although several successful solutions have been raised, their efficacy and reliability have not been fully substantiated. This work aims to present a simple, economic and effective acetabular reconstructive technique to resolve the massive acetabular bone defect in DDH scenario. Methods This is a case series and observational study investigating the effectiveness and safety of extra‐articular blocking technique in patients diagnosed as DDH of Crowe type II‐III and Hartofilakidis B. Sixteen consecutive patients indicated for extra‐articular blocking and treated with total hip arthroplasty were enrolled in this series from January 2019 to August 2020. The outcome measures included the surgical indicators such as acetabular coverage, prosthesis position, operational time, medical cost, and short‐term follow‐up indicators such as complications profile, patient‐reported functional scales, overall recovery after surgery, and radiographic bone integration and remodeling. Their medical documentation and follow‐up records were carefully reviewed with ethical approval. Results The mean values of postoperative acetabular component inclination and anteversion were 42.3° ± 2.1° and 16.4° ± 1.8°, with an average acetabular coverage of 92.1%. The mean cost reduction for patients treated with this technique compared with those treated with trabecular metal augmentation was 15.3%. The mean time until walking under full‐weight bearing decreased by 3.5 weeks compared with patients treated with autologous bone grafting. Within an average observational period of 18 months, the mean improvements in Harris hip score and WOMAC score were 31 and 22 points, respectively, which were identical to those with bone graft and metal augmentation techniques. No complications such as dislocation, acetabular loosening, periprosthetic joint infection, and limb length discrepancy were recorded. No signs of translucent line formation, third‐party reaction, and wear‐associated osteolysis were identified. Conclusion The extra‐articular blocking can work simply and effectively to address acetabular bone defect in DDH patients of Crowe II–III and Hartofilakidis B, as evidenced by cost‐effectiveness and instant weight‐bearing advantages, low failure rate, and early osteointegration and remodeling. |
| first_indexed | 2024-04-09T18:08:51Z |
| format | Article |
| id | doaj.art-53da6df2b2e74d1a8324948faf03b12f |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-09T18:08:51Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-53da6df2b2e74d1a8324948faf03b12f2023-04-14T04:21:20ZengWileyOrthopaedic Surgery1757-78531757-78612023-04-011541187119510.1111/os.13688Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the HipZhonghua Xu0Ziqiang Li1Jie Li2Yiling Zhang3Min Wang4Yuan Zhang5Joint Disease & Sport Medicine Center, Department of Orthopedic Surgery Xinqiao Hospital, Army Medical University Chongqing ChinaDepartment of Orthopedics People's Hospital of Linshui Guang'an ChinaJoint Disease & Sport Medicine Center, Department of Orthopedic Surgery Xinqiao Hospital, Army Medical University Chongqing ChinaDepartment of Technology Longwood Valley MedTech Beijing ChinaJoint Disease & Sport Medicine Center, Department of Orthopedic Surgery Xinqiao Hospital, Army Medical University Chongqing ChinaJoint Disease & Sport Medicine Center, Department of Orthopedic Surgery Xinqiao Hospital, Army Medical University Chongqing ChinaObjective The reconstruction of acetabular bone defect in developmental dysplasia of the hip (DDH) is a great challenge. Although several successful solutions have been raised, their efficacy and reliability have not been fully substantiated. This work aims to present a simple, economic and effective acetabular reconstructive technique to resolve the massive acetabular bone defect in DDH scenario. Methods This is a case series and observational study investigating the effectiveness and safety of extra‐articular blocking technique in patients diagnosed as DDH of Crowe type II‐III and Hartofilakidis B. Sixteen consecutive patients indicated for extra‐articular blocking and treated with total hip arthroplasty were enrolled in this series from January 2019 to August 2020. The outcome measures included the surgical indicators such as acetabular coverage, prosthesis position, operational time, medical cost, and short‐term follow‐up indicators such as complications profile, patient‐reported functional scales, overall recovery after surgery, and radiographic bone integration and remodeling. Their medical documentation and follow‐up records were carefully reviewed with ethical approval. Results The mean values of postoperative acetabular component inclination and anteversion were 42.3° ± 2.1° and 16.4° ± 1.8°, with an average acetabular coverage of 92.1%. The mean cost reduction for patients treated with this technique compared with those treated with trabecular metal augmentation was 15.3%. The mean time until walking under full‐weight bearing decreased by 3.5 weeks compared with patients treated with autologous bone grafting. Within an average observational period of 18 months, the mean improvements in Harris hip score and WOMAC score were 31 and 22 points, respectively, which were identical to those with bone graft and metal augmentation techniques. No complications such as dislocation, acetabular loosening, periprosthetic joint infection, and limb length discrepancy were recorded. No signs of translucent line formation, third‐party reaction, and wear‐associated osteolysis were identified. Conclusion The extra‐articular blocking can work simply and effectively to address acetabular bone defect in DDH patients of Crowe II–III and Hartofilakidis B, as evidenced by cost‐effectiveness and instant weight‐bearing advantages, low failure rate, and early osteointegration and remodeling.https://doi.org/10.1111/os.13688Biomimetic reconstructionBlocking screwBone defectDevelopmental dysplasia of the hipOsteointegration |
| spellingShingle | Zhonghua Xu Ziqiang Li Jie Li Yiling Zhang Min Wang Yuan Zhang Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip Orthopaedic Surgery Biomimetic reconstruction Blocking screw Bone defect Developmental dysplasia of the hip Osteointegration |
| title | Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip |
| title_full | Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip |
| title_fullStr | Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip |
| title_full_unstemmed | Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip |
| title_short | Extra‐articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip |
| title_sort | extra articular blocking technique to resolve severe acetabular bone defect in developmental dysplasia of the hip |
| topic | Biomimetic reconstruction Blocking screw Bone defect Developmental dysplasia of the hip Osteointegration |
| url | https://doi.org/10.1111/os.13688 |
| work_keys_str_mv | AT zhonghuaxu extraarticularblockingtechniquetoresolvesevereacetabularbonedefectindevelopmentaldysplasiaofthehip AT ziqiangli extraarticularblockingtechniquetoresolvesevereacetabularbonedefectindevelopmentaldysplasiaofthehip AT jieli extraarticularblockingtechniquetoresolvesevereacetabularbonedefectindevelopmentaldysplasiaofthehip AT yilingzhang extraarticularblockingtechniquetoresolvesevereacetabularbonedefectindevelopmentaldysplasiaofthehip AT minwang extraarticularblockingtechniquetoresolvesevereacetabularbonedefectindevelopmentaldysplasiaofthehip AT yuanzhang extraarticularblockingtechniquetoresolvesevereacetabularbonedefectindevelopmentaldysplasiaofthehip |