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Abstract: The combined anteversion technique has been proposed recently and proved to be an applicable technique in general THA. The corresponding author routinely applied this approach to DDH patients in clinical practice. The current study aimed to provide clinical evidence for this approach. We studied 35 DDH patients (47 hips). Every patient underwent pelvic CT scans before and after surgery and the HHs was recorded. The data indicate a high accuracy of controlling components orientation and satisfactory clinical outcomes. Using this approach, we reduced dislocation risk and got better impingement free range of motion. Therefore, we conclude that combined anteversion is effective for DDH patients who receive a THA. This approach could guarantee stable and functioning joints for DDH patients receiving THA. [Copyright &y& Elsevier]

Abstract: This study details a method using rapid prototyping (RP) technique to assist in acetabular revision with complex bone defects. Hemi-pelvic RP models were built among 25 patients with complex acetabular bone defects. Each patient was scheduled to undergo revision using either commercially available or customized cages based on individualized RP models. Average follow-up was 4.4years (range, 1 to 9years). The average Harris hip score was 36.1 (range, 20 to 58) preoperatively and reached an average of 82.6 (range, 60–96) at the last follow-up. No mechanical failure or loosening was observed. One patient experienced hip dislocation 4days postoperatively. The resultant findings of this study merit consideration of RP as a helpful clinical complement for dealing with some complex bone defect of acetabulum. [Copyright &y& Elsevier]

Abstract: Autogenous impaction grafting was performed to improve acetabular cup coverage in 68 patients (78 hips) with developmental dysplasia of the hip (DDH) after total hip arthroplasty, and the patients were then monitored for a mean duration of 5.5years. No cup revisions were required, and there was no radiographic loosening. The host–graft interface became indistinct by 6weeks after surgery, trabecular bone formation was seen by 12weeks, and definite trabecular reorientation was seen by 20months. At the last follow-up examination, the mean cup coverage was 97.7%, whereas mean coverage by bone grafting was 27.9%. Among 12 patients with most of the bone graft placed at the absolutely protruded area of the cup, the cup coverage provided by the bone graft decreased from 95.4% immediately after surgery to 20.7% by the final follow-up examination. Bone-particle grafting can provide a satisfactory integration speed and a low incidence of displacement and ectopic ossification. [Copyright &y& Elsevier]

Abstract: The precise relationship between developmental dysplasia of the hip and dislocation among patients after total hip arthroplasty has not been well clarified. A total of 820 patients with developmental dysplasia of the hip who underwent total hip arthroplasty from January 2000 to December 2009 were categorized according to Crowe classification, and postoperative dislocation rates were analyzed among subgroups. The overall dislocation rate was 2.93%. No statistically significant differences in dislocation rates were observed between these with and without subtrochanteric osteotomy. Femoral head size was the only factor with significant difference between the dislocated and stable groups, especially when femoral head diameter increased from 28 to 32 mm. Of all dislocations, 69.6% were anterior dislocation, and the degree of cup anteversion and combined anteversion of anterior dislocators was higher than that of the posterior dislocators (P = .0082 and P = .001). [Copyright &y& Elsevier]

Abstract: This study was designed to evaluate the midterm results of hybrid total hip arthroplasty in a consecutive series of 45 Chinese patients with osteoarthritis secondary to dysplastic hip. The average follow-up was 6.6 years. A total of 24 hips were classified as dysplasia, 20 hips as low dislocation, and 13 hips as high dislocation. The preoperative Harris score was 46.19 ± 18.01, which improved to 91.78 ± 3.52 at the final follow-up. The rate of polyethylene liner wear was 0.27 mm/y. Osteolysis was identified around 5 acetabular components and 13 femoral components. With the use of loosening or revision as the end point for failure, the survival rate was 1.0. We suggest that hybrid total hip arthroplasty in Chinese developmental dysplasia of hip patients has favorable results at midterm follow-up, even though their lifestyle includes more deep flexion of the hip. There is no significant difference of postoperative Harris score with increasing severity of dysplasia. [Copyright &y& Elsevier]