Impaction bone grafting with morselized bone and bone paste for acetabular defects in adult Crowe III type developmental dysplasia of the hip

doi:10.3969/j.issn.2095-4344.2017.22.003

Abstract

Abstract:

BACKGROUND: Considering the risk of lack of bone in revision and the bone coverage of component, it is advisable to use bone grafting to increase bone stock in patients with adult Crowe type III developmental dysplasia of the hip (DDH) in the first total hip arthroplasty (THA).

OBJECTIVE: To investigate the effectiveness of impaction bone grafting with morselized bone and bone paste for acetabular defects of adult Crowe type III DDH in THA.

METHODS: Forty cases (45 hips) of Crowe type III DDH were enrolled, including 8 males and 32 females, aged 31-68 years. All the components were reconstructed at the anatomic acetabulum combined with deepening acetabulum and putting the centre of rotation medially and distally during THA procedures. The patients were all followed up and evaluated with Harris score, limp length, displacement of the centre of rotation, cup coverage, and postoperative complications.

RESULTS AND CONCLUSION: The average follow-up was 32.7 months. Acetabular rotation centers of all the cases were recovered (near) to normal. The incisions healed by first intention and there was no complication such as infection, dislocation, prosthesis loosening. The acetabular cup prosthesis did not displace and was covered well by bone at the last follow-up, the grafted bone particles got radiological osseointegration and the bone sclerosis zone disappeared. No radiolucent lines and screw fracture were detected. The Harris scores of affected hips at the last follow-up were significantly higher than those before surgery(P=0). The average leg length was increased (2.31±0.18) cm. The mean cup coverage was 78.1%. The postoperative horizontal and vertical distance of the hip center were shorter than those before surgery (P=0). Reconstructing the acetabulum with autogenous morselized bone graft impaction can effectively restore the acetabular coverage, maintain the stability of acetabular cup and provide better relative bone stock in THA for Crowe type III DDH in adult, and moreover, the short-term effect is satisfactory.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Arthroplasty, Replacement, Hip, Transplantation, Autologous, Tissue Engineering

CLC Number:

R318

Wu Tian-hao, Guo Jiang, Zhang Cai-dong, Fan Zhong-wei, Wang Sen, Liu Shao-feng, Tan Mei-yun.

Impaction bone grafting with morselized bone and bone paste for acetabular defects in adult Crowe III type developmental dysplasia of the hip

[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(22): 3458-3463.

Figures/Tables 2

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