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Staged total hip arthroplasty in a patient with hip dysplasia and a large pertrochanteric bone cyst.

ABSTRACT: Hip arthroplasty in young patients requires thoughtful preoperative planning. Patients with proximal femoral bone loss complicate this planning and may require a staged procedure to optimize implant insertion. We report on a case of a 26-year-old woman with secondary hip arthritis from developmental dysplasia of the hip and a large pertrochanteric bone cyst that was treated with staged total hip arthroplasty. The cyst was decompressed and filled with an osteoconductive and osteoinductive bone graft substitute called EquivaBone. One year later, the patient underwent a successful primary total hip arthroplasty. Fifteen-month follow-up after her hip replacement revealed resolution of postoperative pain and significant functional improvement.

SUBMITTER: Langston JR

PROVIDER: S-EPMC4957267 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Staged total hip arthroplasty in a patient with hip dysplasia and a large pertrochanteric bone cyst.

Langston Joseph R JR DeHaan Alexander M AM Huff Thomas W TW

Arthroplasty today 20160524 2

Hip arthroplasty in young patients requires thoughtful preoperative planning. Patients with proximal femoral bone loss complicate this planning and may require a staged procedure to optimize implant insertion. We report on a case of a 26-year-old woman with secondary hip arthritis from developmental dysplasia of the hip and a large pertrochanteric bone cyst that was treated with staged total hip arthroplasty. The cyst was decompressed and filled with an osteoconductive and osteoinductive bone gr ...[more]

PMID: 28326400

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| S-EPMC8430435 | biostudies-literature

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Endoscopic Shelf Acetabuloplasty for Treating Acetabular Large Bone Cyst in Patient With Dysplasia.

Project description:Acetabular bone cyst is usually associated with dysplastic secondary osteoarthritis of the hip joint. Acetabular reorientation osteotomy is one of the most common therapeutic options for treating patients with hip dysplasia. However, it may be too invasive for athletes and can also lead to some complications including intraoperative fracture and postoperative bone necrosis especially in patients with acetabular large bone cysts. Endoscopic shelf acetabuloplasty offers a less invasive option for athletic patients with dysplasia of severity greater than those indicated for isolated hip arthroscopy. This Technical Note demonstrates endoscopic shelf acetabuloplasty with bone grafting, simultaneously addressing a large bone cyst and acetabular undercoverage, as part of a comprehensive approach addressing chondrolabral pathology while restoring capsular integrity in an athlete with moderate dysplasia.

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Total hip arthroplasty in an adult patient with pelvic dysmorphism, unilateral sacroiliac joint autofusion, and developmental hip dysplasia.

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| S-EPMC8857266 | biostudies-literature

Simultaneous versus staged bilateral total hip arthroplasty: a systematic review and meta-analysis

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Acetabular Bone Defect in Total Hip Arthroplasty for Crowe II or III Developmental Dysplasia of the Hip: A Finite Element Study.

Project description:Background:The purpose of this study was to establish the finite element analysis (FEA) model of acetabular bone defect in Crowe type II or III developmental dysplasia of the hip (DDH), which could evaluate the stability of the acetabular cup with different types of bone defects, different diameters of femoral ceramic heads, and the use of screws and analyze the stress distribution of screws. Methods:The FEA model was based on the CT scan of a female patient without any acetabular bone defect. The model of acetabular bone defect in total hip arthroplasty for Crowe II or III DDH was made by the increasing superolateral bone defect area of the acetabular cup. Point A was located in the most medial part of the acetabular bone defect. A 52?mm PINNACLE cup with POROCOAT Porous coating was implanted, and two screws (the lengths were 25?mm and 40?mm) were implanted to fix the acetabular cup. The stability of the acetabular cup and the von Mises stress of point A and screws were analyzed by a single-legged stance loading applied in 1948?N (normal working). The different diameters of the femoral ceramic head (28?mm, 32?mm, and 36?mm) were also analyzed. Results:The von Mises stress of point A was gradually increased with the increasing uncoverage values. When the uncoverage values exceeded 24.5%, the von Mises stress of point A without screws increased significantly, leading to instability of the cup. Screws could effectively reduce the von Mises stress of point A with uncoverage values of more than 24.5%. However, the peak von Mises stress in the screws with the uncoverage values that exceeded 24.5% was considerably increased. The diameter of the femoral ceramic head had no significant effect on the von Mises stress and the stability of the acetabular cup. Conclusions:We recommend that uncoverage values of less than 24.5% with or without screw is safe for patients with Crowe II or III DDH.

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Project description:The application of distraction osteogenesis through the use of magnet-operated, remote-controlled intramedullary lengthening continues to provide new opportunities for accurate limb equalization. While limb-length discrepancy and deformity can be addressed by total hip arthroplasty alone, the magnitude of correction is limited by the soft-tissue envelope and complications such as sciatic nerve palsy. This 3-patient case series presents the combination of staged ipsilateral total hip arthroplasty and retrograde intramedullary femoral nail lengthening for the correction of both deformity and limb-length discrepancy. Our results report leg-length equalization, independent ambulation without assistive devices, and excellent bone and functional outcomes without complications, demonstrating that this combined technique can be used to achieve targeted lengthening and deformity correction.

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