Acetabular Reconstruction with Autogenous Femoral Head Graft in Patients with Total Hip Prosthesis Due to Crowe Type 2 or 3 Developmental Hip Dysplasia

Year 2016, , 23 - 29, 01.01.2016

Mehmet Faruk Çatma Mehmet Atıf Erol Aksekili Kasım Kılınçarslan Bahar Anaforoğlu İzzet Korkmaz Murat Altay

https://doi.org/10.5505/abantmedj.2016.04834

Abstract

INTRODUCTION: We aimed to evaluate our short- mid term results in acetabular reconstruction with autogenous femoral head graft in patients with total hip prosthesis due to developmental hip dysplasia.METHODS: Sixteen patients 15 male, 1 female with developmental hip dysplasia were operated between 2010 and 2013. Grafting was done when acetabular component was covered less than 80% based on pre operative radiological findings and intra operative observations. Pelvis and hip anterior- posterior x-rays were used in follow up. Stability of the acetabular component was evaluated based on criteria defined by Callaghan et al. coverage of acetabular component by bone graft was measured based on DeLee and Charnley zones. Center edge angle was measured to evaluate acetabular covering.RESULTS: Mean age of the patients at time of operation was 50.6 ±10.2 38-73 . According to Crowe classification; 8 of the hips were type 1 and 8 were type 2. Mean follow up period from operation to last control was 30,5±9.9 12-48 months. Radiological graft incorporation was detected in all patients. None of the patients showed any neurovascular complications, infection or dislocation. In measurements based on DeLee and Charnley zones; graft supported acetabular cup coverage in zone 1 in 10 hips 62,5% and in zone 1 and 2 in 6 hips 37,5% . Mean Center edge angle was 47.75 35-80 , horizontally coverage of acetabular component was 66,6 % 50-78 .DISCUSSION AND CONCLUSION: Acetabular reconstruction with autogenous femoral head graft in developmental hip dysplasia is one of the successfull methods.

Keywords

Dysplastic hip, total hip arthroplasty

Crowe Tip 2 veya Tip 3 Gelişimsel Kalça Displazisi Nedeniyle Total Kalça Protezi Olan Hastalarda Otojen Femur Başı Greftiyle Asetabulum Rekonstrüksiyonu

Abstract

GİRİŞ ve AMAÇ: Bu makalenin amacı gelişimsel kalça displazisinde uygulanan total kalça artroplastisinde femoral başın otogreft olarak kullanılarak asetabulumun yeniden yapılandırılmasındaki kısa-orta dönemdeki sonuçlarımızı değerlendirmektir.YÖNTEM ve GEREÇLER: 2010-2013 tarihleri arasında Crowe Tip 1 ve 2 gelişimsel kalça displazisi olan 16 hasta 15 erkek, 1 kadın ameliyat edildi. Ameliyat öncesi radyolojik bulguları ve ameliyat sırasındaki gözlemler değerlendirilerek asetabular komponentin %80 den az örtünmesi görüldüğünde greftleme uygulandı. Pelvis ve kalça anteroposterior grafileri ile takipleri yapıldı. Callaghan ve ark. tarafından tanımlanan kriterler dikkate alınarak asetabuler komponentin stabilitesi değerlendirildi. Kemik greftinin asetabular komponenti örtünmesi de DeLee ve Charnley zonlarına göre ölçüldü. Merkez kenar açısı ölçülerek asetabular örtünme değerlendirildi.BULGULAR: Cerrahi sırasındaki ortalama yaş 50.6±10.2 38-73 . Crowe sınıflamasına göre 8 tanesi tip 1, 8 tanesi tip 2 kalçaydı. Hastalar cerrahiden son kontrollerine kadar geçen takip süreleri ortalama 30,5±9.9 12-48 ay olarak bulundu. Tüm hastalarda greftlerde radyolojik kaynama görüldü. Hiçbir hastada nörovasküler bir komplikasyon, enfeksiyon veya çıkık görülmedi. DeLee ve Charnley zonları esas alarak yapılan ölçümlerde 10 kalçada %62,5 zone 1, 6 kalçada %37,5 zone 1 ve 2’de greftin asetabular cup örtünmesine destek olduğu saptandı. Merkez kenar açısı ölçümü ortalaması 47.75 35-80 , yatay olarak asetabuler komponentin örtünmesi oranıda % 66,6 50-78 olarak bulundu.TARTIŞMA ve SONUÇ: Gelişimsel kalça displazili hastalarda asetabulum rekonstrüksiyonunda femoral başın otogreft olarak kullanılması tercih edilelebilecek başarılı yöntemlerden biridir

Keywords

Displastik kalça, total kalça

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