- 作者：Jiawei Xu ; MD ; Chen Xu ; MD ; Yuanqing Mao ; MD ; PhD ; Jincheng Zhang ; MD ; PhD ; Huiwu Li ; MD ; PhD ; Zhenan Zhu ; MD ; PhD
- 关键词：posterosuperior cup placement ; three-dimensional coverage ; developmental dysplasia of the hip with high dislocation ; anatomic acetabular reconstruction ; total hip arthroplasty
- 刊名：The Journal of Arthroplasty
- 出版年：2016
- 出版时间：June 2016
- 年：2016
- 卷：31
- 期：6
- 页码：1233-1239
- 全文大小：2986 K
Methods
Using pelvic computed tomography and image processing, we developed a two-dimensional mapping technique to demonstrate the distribution of preoperative three-dimensional cup coverage at the true acetabulum, determined the postoperative location of the acetabular cup, and calculated postoperative three-dimensional coverage for 16 Crowe type-IV dysplastic hips in 14 patients with a mean age of 52 years (33-78 years) who underwent total hip arthroplasty. Mean follow-up was 6.3 years (5.5-7.3 years).
Results
On preoperative mapping, the maximum three-dimensional coverage using a 44-mm cup was 87.31% (77.36%-98.14%). Mapping enabled the successful replacement of 16 hips using a mean cup size of 44.13 mm (42-46 mm) with posterosuperior placement of the cup. Early weight-bearing and no prosthesis revision or loosening during follow-up were achieved in all patients. The postoperative two-dimensional coverage on anteroposterior radiographs and three-dimensional coverage were 96.15% (89.49%-100%) and 83.42% (71.81%-98.50%), respectively.
Conclusion
This technique may improve long-term implant survival in patients with Crowe-IV developmental dysplasia of the hip undergoing total hip arthroplasty by allowing the use of durable bearings, increasing host bone coverage, ensuring initial stability, and restoring the normal hip center.