Nishi Masanori, Atsumi Takashi, Yoshikawa Yasushi, Nakanishi Ryosuke, Watanabe Minoru, Ishikawa Tsubasa, Usui Yuki, Tatsuo Tokito, Kudo Yoshifumi
Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan.
Department of Orthopaedic Surgery, Sassa General Hospital, Tokyo, Japan.
Hip Int. 2025 Jul;35(4):377-383. doi: 10.1177/11207000251338196. Epub 2025 May 15.
Studies on short-stem total hip arthroplasty (THA) in young patients with developmental dysplasia of the hip (DDH) are limited, with no studies on long-term outcomes. Our study aimed to investigate whether the Mayo conservative hip stem demonstrates favourable mid- to long-term outcomes in these patients.
This retrospective study included 42 patients (50 joints) with DDH aged <55 years who underwent THA using the Mayo conservative hip stem and excluded those with a follow-up period <5 years. Radiographic evaluation involved comparison of the immediate postoperative anteroposterior images with those at the final follow-up. Clinical evaluations utilised the Japanese Orthopaedic Association (JOA) hip score and major postoperative complications, including revision surgery.
The mean age of the patients was 48.8 years, with a median follow-up of 11 years. According to the Crowe classification, 35, 11, and 4 cases were classified as Types I, II, and III, respectively. According to the Dorr classification, 29 and 21 cases were classified as Types A and B, respectively. Radiographically, spot welds were observed in 98% of joints in zones 2 or 6, whereas stress shielding was evident in 94% (zone 1) and 54% (zone 7) of the joints. Stem sinking ⩾3 mm was observed in 2 joints. No periprosthetic femoral fractures, dislocations, or infections were observed.
The Mayo conservative stem in young patients with DDH resulted in favourable mid- to long-term outcomes, including stability and bone preservation. The stem is an effective treatment strategy for these patients.
关于年轻发育性髋关节发育不良(DDH)患者的短柄全髋关节置换术(THA)的研究有限,且尚无长期疗效的研究。我们的研究旨在调查Mayo保守型髋关节柄在这些患者中是否具有良好的中长期疗效。
这项回顾性研究纳入了42例年龄小于55岁、接受使用Mayo保守型髋关节柄进行THA的DDH患者(50个关节),并排除了随访期小于5年的患者。影像学评估包括将术后即刻前后位图像与末次随访时的图像进行比较。临床评估采用日本骨科协会(JOA)髋关节评分以及主要术后并发症,包括翻修手术。
患者的平均年龄为48.8岁,中位随访时间为11年。根据Crowe分类,分别有35例、11例和4例被分类为I型、II型和III型。根据Dorr分类,分别有29例和21例被分类为A型和B型。影像学上,在2区或6区98%的关节中观察到点焊,而在1区94%和7区54%的关节中观察到明显的应力遮挡。在2个关节中观察到柄下沉≥3 mm。未观察到假体周围股骨骨折、脱位或感染。
Mayo保守型柄在年轻DDH患者中产生了良好的中长期疗效,包括稳定性和骨保留。该柄是这些患者的一种有效治疗策略。