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BACKGROUND: There are some differences in acetabular anatomical parameters among different regions and different populations, which are very important for the diagnosis and treatment of acetabular diseases. However, the characteristics of acetabular imaging parameters in the Guizhou population are still unclear. OBJECTIVE: To analyze the imaging parameters of acetabular plain radiographs, so as to provide a reference for the diagnosis and treatment of acetabular diseases and the design and installment of the acetabular prosthesis. METHODS: Adult patients who underwent anteroposterior radiography of both hip joints at the Affiliated Hospital of Guizhou Medical University from January 2015 to February 2017 were collected. The acetabular radiographic parameters were measured using the medical imaging software SIEMENS Syngo.Plaza PACS. The data were grouped and analyzed according to age, sex and left and right sides. Pearson correlation analysis was performed between acetabular parameters. The data in the current study were compared with domestic and foreign studies containing the same type of data. RESULTS AND CONCLUSION: (1) Sharpe angle, center edge angle, anteversion angle, abduction angle, acetabular depth, acetabular diameter, modified acetabular index, and acetabular head index were (39.70±3.65)°, (31.10±6.03)°, (19.17±4.26)°, (39.71±3.67)°, (1.16±0.22) cm, (6.45±0.52) cm, (0.33±0.03), and (84.72±4.19)%, respectively. (2) There were statistical differences in Sharp angle between males and females at different age groups (P < 0.05); statistical differences in abduction angle were found in males among different age groups (P < 0.05). (3) There were differences in Sharp angle, center edge angle, anteversion angle, abduction angle, acetabular depth and acetabular diameter between genders. Sharp angle, anteversion angle and abduction angle were smaller in males than those in females (P < 0.05). The center edge angle, acetabular depth, and acetabular diameter were greater in males than that in females (P < 0.05). (4) There were no significant differences in acetabular parameters between the sides. (5) There were differences in the acetabular imaging parameters of the population in the Guizhou district when compared with the same type of data from domestic and foreign studies. Taken together, the acetabular imaging parameters of the population in Guizhou have certain characteristics. The regional features of acetabular imaging parameters should be fully considered in the clinical diagnosis and treatment of acetabular diseases to achieve greater clinical benefits. [ABSTRACT FROM AUTHOR]

Due to the change in the structure of the proximal femur and acetabulum in patients with developmental dysplasia of the hip, total hip arthroplasty (THA) was difficult to perform for surgeons. To elevate the acetabular coverage rate, we developed a technique in the use of a patient-specific instrumentation (PSI) graft in patients with developmental dysplasia of hip (DDH) undergoing surgery. This study aims to evaluate the peri-operative outcomes of THA with PSI graft in patients with DDH. This study recruited 6 patients suffering from Crowe I DDH with secondary Grade IV osteoarthritis. All the patients underwent THA with PSI graft performed by a well-experienced surgeon. Perioperative outcomes included surgical procedures, blood loss during operation, the volume of blood transfusion, length of hospitalization, complications, and the mean difference in hemoglobin levels before and after surgery. All the outcomes analyzed were assessed by mean and standard deviation. The average duration of the surgical procedure was found to be 221.17 min, with an SD of 19.65 min. The mean blood loss during the operation was 733.33 mL, with an SD of 355.90 mL. The mean length of hospital stay was calculated to be 6 days, with an SD of 0.89 days. Furthermore, the mean difference between the pre- and postoperative hemoglobin levels was 2.15, with an SD of 0.99. A total of three patients received 2 units of leukocyte-poor red blood cells (LPR) as an accepted blood transfusion. There were no reported complications observed during the admission and one month after the operation. This study reported the peri-operative outcomes in the patients with DDH who underwent THA with PSI graft. We found that THA with PSI graft would provide a safe procedure without significant complications. We assumed that the PSI graft in THA may increase the coverage rate of the acetabulum, which may increase the graft union rates. Further cohort studies and randomized controlled trials were needed to confirm our findings. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between acetabular width, three-dimensional (3D) simulation, and surgical results in total hip arthroplasty patients who have developmental dysplasia of the hip (DDH). This retrospective study included 216 DDH cases. Inner and outer acetabular width (OAW) was measured at the plane passing through the center of acetabular fossa. 3D simulation and 2D standard templating were performed. The actual cup size and the use of augments during surgery were recorded. Association among the indices and their distribution in different types of DDH were analyzed. A difference of 13 to 14 millimeters (mm) was found between the inner acetabular width and actual cup size used in type II, III, and IV cases, while the difference was 0.2 to 3.6 mm for OAW. The accuracy of 2D templating and 3D simulation in predicting cup size was comparable in Crowe type I (86.5 versus 76%, P =.075), type II (72.7 versus 51.5%, P =.127), and type III (93.3 versus 66.7%, P =.169). The 3D simulation was significantly more accurate in Crowe type IV (89.1% versus 60.9%, P =.001). Augments and bone grafts were significantly more commonly used in type II (25%) than in the other types (0 to 6.5%). OAW more accurately predicted actual cup size than inner acetabular width. The supero-lateral acetabular bone defects in type II cases require additional attention. Compared with 2D templating, 3D simulation is more accurate in predicting actual cup size in dysplastic hips with severe deformity and may be recommended in these selected cases, especially for Crowe IV patients. [ABSTRACT FROM AUTHOR]

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Abstract Background To study the segmental uncoverage ratio (UCR) of a 44-mm cup model placed in a true acetabulum of Crowe type-IV developmental dysplasia of the hip via 3-Dimensional (3D) implantation simulation. Methods Qualified CT imaging data of 26 patients (involving 30 hips) with Crowe type-IV DDH were imported into Mimics software for reconstruction. Then a 44-mm eggshell cup model was placed in a true acetabulum. First, total uncoverage ratio (TUCR) was measured. Then the virtual cup was divided into 4 segments according to the quadrant setting of the true acetabulum, i.e., anterior-superior (A-S) segment, anterior-inferior (A-I) segment, posterior-superior (P-S) segment and posterior-inferior (P-I) segment. The UCRs of the aforementioned segments were measured, i.e., anterior-superior uncoverage ratio (A-SUCR), anterior-inferior uncoverage ratio (A-IUCR), posterior-superior uncoverage ratio (P-SUCR) and posterior-inferior uncoverage ratio (P-IUCR). The acetabular height and anterior-posterior diameter on the 3-D model were also calculated. Statistic analyses were performed by using SPSS software package. Results TUCR was 0.2958 ± 0.1003 (95% [CI], 0.1020 to 0.5400) in this cohort of Crowe Type-IV hips. P-SUCR had the greatest value among all the segmental UCRs (0.1012 ± 0.0435, 95% confidence interval [CI],0.0152 to 0.1914) and the most significant positive correlation with TUCR (Pearson correlation = 0.889, p

Objectives: The aim of our study is to determine the surgical outcome and rates of complication in patients undergoing surgical treatment for osteoarthritis of the hip joint with total hip arthroplasty and compare it with hip resurfacing procedures. Study Design: A prospective cohort study. Period: Five years duration from January 2011 to December 2016. Setting: Tertiary Care Centre in Karachi, Pakistan. Materials and methods: The study population consisted of n= 170 patients (n= 110 patients undergoing cementless THA and n=60 patients undergoing hip resurfacing procedures). The inclusion criteria was all the patients who came to our outpatient clinic, with unilateral or bilateral osteoarthritis (grade 3,4) of the hip joint requiring surgical treatment, were fit for surgery and gave informed consent to participate in the study. All the procedures were done by the same team of surgeons at the same institute in series under general anesthesia. Data was collected in a pre-designed proforma. Postoperatively the patients were restricted to a reduction of weight bearing by half for the first six weeks, and were involved in physiotherapy till discharge from the hospital. The patients from both groups received the same thromboembolic and infection prophylaxis. Data was analyzed using IBM SPSS version 22. Results: In our study we found that the rates of reoperation had statistically significant differences, being n= 5 in THA group and n=9 in resurfacing group having a p value of 0.019. In the resurfacing group n= 4 patients had fractures of the femoral neck. All the revision surgeries were undertaken utilizing the posterolateral approach, n= 2 patients were revised utilizing cementless femoral stems while n=2 were revised utilizing cemented femoral stem, n= 5 patients were revised to total hip arthroplasty procedure on account of aseptic loosening. No dislocations were observed after the revision surgical procedures. There was no statistically significant difference in the total rates of complications among the two groups, having a p value of 0.44. The pre-operative Harris hip scores were similar in the two groups having a p value of 0.2. Conclusion: According to the results of our study the outcome in the both the cementless total hip arthroplasty and hip resurfacing procedure are similar in terms of implant survival and clinical results however rate of complication is higher in the patients undergoing hip resurfacing technique and needed revision surgeries. The patients undergoing hip resurfacing had better mobility post operatively, and hence this consideration is to be made during patient selection, as hip resurfacing is preferred by younger patients due to its higher functional outcomes. [ABSTRACT FROM AUTHOR]

There is limited information about the effect of hip center location on gait parameters of knee and ankle. This study aimed to compare anatomical vs. high hip center arthroplasty according to gait parameters of knee and ankle and investigate whether the high hip center has any adverse effect on these joints or not. 20 patients who underwent unilateral total hip arthroplasty (Group 1; 10 patients with anatomical reconstruction, Group 2; 10 patients with high hip center) due to Crowe type III-IV developmental dysplasia of the hip and completed 2 years of follow-up were included. The patients were examined by 3-D gait analysis. The maximum extension of the knee on the operated side was lower in Group 2 (p = 0.044). Longitudinal knee joint force was higher in Group 2 on both operated (p = 0.041) and non-operated sides (p = 0.031). Lateral knee joint force was also higher in Group 2 (p = 0.023). No significant difference was detected in ankle parameters. Unilateral high hip center has been shown to restrict the dynamic knee range of motion on the operated side and increase the knee load on both sides, thus putting the knees at risk for osteoarthritis. Level III, Retrospective comparative study. • Unilateral high hip center adversely affected the gait parameters of the knee. • Dynamic knee range of motion was restricted in patients with high hip center. • Load on the knee was increased in patients with high hip center. [ABSTRACT FROM AUTHOR]

Treatment of fractures in patients with developmental dysplasia of hip is not clear. In patients without any pre-existing hip pathology, open or closed reduction and internal fixation is used to treat hip fractures. Total arthroplasty is used as a salvage procedure in hip fractures of young patients. Total arthroplasty serves perfect functional results in elderly patients with developmental dysplasia of hip. We presented two multi-trauma patients with developmental dysplasia of hip, and their hip fractures were treated with total arthroplasty. Painless and functional hip joints were obtained, and patients were mobilized early to prevent systemic complications. We think that total arthroplasty is the most convenient treatment method for hip fractures in patients with developmental dysplasia of hip. [ABSTRACT FROM AUTHOR]