Department of Orthopedic Surgery and Traumatology, Medipol University, İstanbul, Turkiye.
Department of Orthopedic Surgery and Traumatology, Pendik Hospital, İstanbul, Turkiye.
Turk J Med Sci. 2023 Aug 11;53(5):1448-1457. doi: 10.55730/1300-0144.5712. eCollection 2023.
BACKGROUND/AIM: Developmental dysplasia of the hip (DDH) is the most common cause of secondary hip arthrosis. The primary purpose of this study was to assess the results of an oversized hemispherical cup via the press-fit technique used for Crowe type II and III DDH without screws and to determine if adequate medialization and initial stability of the acetabular component would allow us to avoid screw and graft use.
Between February 2012 and May 2020, the current study analyzed 43 hips with Crowe type II and III DDH treated with a porous-coated cup by placing the press-fit technique or screw. The acetabular cup was fixed with the press-fit technique without additional screws in 27 hips and with screws in 16 hips. The inclusion criterion in this study was a minimum 2-year-period after the surgery.
The mean duration of follow-up was 6.83 2.67 years in the press-fit group and 6.21 2.01 years in the screw group. The mean age of the patients was 47.96 12.37 years in the press-fit group and 50.5 12.37 years in the screw group. Measurements revealed that the hip center of rotation (HCR) was located more medially and superiorly postoperatively than preoperatively in both groups. The mean cup coverage in the screw group was 85.58% 7.51% (75.3%-97.2%), while it was less than 90.41% 6.15% (76.3%-98.2%) in the press-fit group (p = 0.038). No component was revised because of loosening, and all of the implants were radiologically stable within the observation period. No statistically significant differences were observed regarding the postoperative limp-length discrepancy between the groups (p = 0.496).
Press-fit implantation of a porous-coated acetabular component without screws can also be used as an alternative method for THA in Crowe type II and III DDH. The initial stability was obtained using the press-fit technique with a small cup positioned more medially and superiorly, which may allow the surgeon to avoid screw and graft use.
背景/目的：发育性髋关节发育不良（DDH）是继发性髋关节骨关节炎最常见的原因。本研究的主要目的是评估 Crowe Ⅱ型和Ⅲ型 DDH 中使用过盈配合技术的超大半球形杯的结果，而不使用螺钉，并确定髋臼组件的充分内侧化和初始稳定性是否允许我们避免使用螺钉和移植物。
2012 年 2 月至 2020 年 5 月，本研究分析了 43 例 Crowe Ⅱ型和Ⅲ型 DDH 患者，采用多孔涂层杯，采用过盈配合技术或螺钉固定。髋臼杯在 27 例中采用过盈配合技术固定，不使用附加螺钉，在 16 例中采用螺钉固定。本研究的纳入标准为手术后至少 2 年的随访期。
过盈配合组的平均随访时间为 6.83 2.67 年，螺钉组为 6.21 2.01 年。过盈配合组患者的平均年龄为 47.96 12.37 岁，螺钉组为 50.5 12.37 岁。两组术后髋关节旋转中心（HCR）位置均较术前更向内侧和上方。螺钉组的杯覆盖率为 85.58% 7.51%（75.3%-97.2%），而过盈配合组为小于 90.41% 6.15%（76.3%-98.2%）（p = 0.038）。在观察期间，没有因松动而修改任何组件，所有植入物均在影像学上稳定。两组术后跛行长度差异无统计学意义（p = 0.496）。
在 Crowe Ⅱ型和Ⅲ型 DDH 中，不使用螺钉的多孔涂层髋臼组件的过盈植入也可以作为 THA 的一种替代方法。使用较小的杯，通过过盈配合技术获得初始稳定性，使杯的位置更向内侧和上方，可以使外科医生避免使用螺钉和移植物。
