Advertisement

Total Hip Arthroplasties for Hartofilakidis Type C1 and C2 High Hip Dislocations Demonstrate Similar Survivorship and Clinical Function at Minimum 10-year Follow-up With Cementless Implants

      Abstract

      Background

      This study aimed to determine the differences in survivorship, clinical function, and complications among patients who have Hartofilakidis Type C1 or C2 developmental dysplasia of the hips and underwent total hip arthroplasty (THA) with cementless implants.

      Methods

      This retrospective study identified 84 Hartofilakidis Type C hips that underwent THA between 2002 and 2011 with a minimum 10-year follow-up (mean, 13 years, range, 10 to 19 years). Survivorship, latest Harris Hip Scores and satisfaction levels, radiographic outcomes (eg, implant stability, rate and length of subtrochanteric shortening transverse osteotomy, leg-length discrepancy, cup position, and orientation), as well as complications (eg, dislocation, periprosthetic fracture, periprosthetic joint infection) were compared to analyze the differences between Hartofilakidis C1 and C2 hips.

      Results

      Between C1 and C2 hips, no difference existed in the 15-year cumulative Kaplan-Meier survivorship, with the endpoint defined as any reoperation (93.1 versus 90.8%), aseptic loosening combined with periprosthetic joint infection (93.1 versus 96.2%), or aseptic loosening (94.8 versus 96.2%), latest Harris Hip Score (87.1 versus 86.1%), vertical (6.1 versus 6.0 mm) and horizontal (11.5 versus 10.3 mm) distance to the anatomic center of rotation, postoperative leg length discrepancy (11.2 versus 15.5 mm), dislocation (5.2 versus 11.5%), stem aseptic loosening (6.9 versus 7.7%), periprosthetic fracture (3.4 versus 7.7%), and intraoperative femoral fracture (32.8 versus 23.1%). However, Type C2 hips demonstrated more severe preoperative leg length discrepancy (66.9 versus 42.5 mm) and required a higher percentage of subtrochanteric shortening transverse osteotomies (84.6 versus 36.2%) that were longer (33.7 versus 26.47 mm) than the Type C1 hips.

      Conclusion

      With cementless cups positioned near the anatomic acetabular center and cementless stems combined with subtrochanteric shortening transverse osteotomies, THAs for the Hartofilakidis Type C1 and C2 hips demonstrated similar survivorship, clinical function, and complications.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Arthroplasty
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hartofilakidis G.
        • Stamos K.
        • Karachalios T.
        • Ioannidis T.T.
        • Zacharakis N.
        Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty.
        J Bone Joint Surg Am. 1996; 78: 683-692
        • Hartofilakidis G.
        • Yiannakopoulos C.K.
        • Babis G.C.
        The morphologic variations of low and high hip dislocation.
        Clin Orthop Relat Res. 2008; 466: 820-824
        • Xu H.
        • Zhou Y.
        • Liu Q.
        • Tang Q.
        • Yin J.
        Femoral morphologic differences in subtypes of high developmental dislocation of the hip.
        Clin Orthop Relat Res. 2010; 468: 3371-3376
        • Wang Z.
        • Li H.
        • Zhou Y.
        • Deng W.
        Three-dimensional femoral morphology in Hartofilakidis type C developmental dysplastic hips and the implications for total hip arthroplasty.
        Int Orthop. 2020; 44: 1935-1942
        • Hartofilakidis G.
        • Babis G.C.
        • Lampropoulou-Adamidou K.
        • Vlamis J.
        Results of total hip arthroplasty differ in subtypes of high dislocation.
        Clin Orthop Relat Res. 2013; 471: 2972-2979
        • Harris W.H.
        Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation.
        J Bone Joint Surg Am. 1969; 51: 737-755
        • Tang H.
        • Du H.
        • Tang Q.
        • Yang D.
        • Shao H.
        • Zhou Y.
        Chinese patients' satisfaction with total hip arthroplasty: what is important and dissatisfactory?.
        J Arthroplasty. 2014; 29: 2245-2250
        • DeLee J.G.
        • Charnley J.
        Radiological demarcation of cemented sockets in total hip replacement.
        Clin Orthop Relat Res. 1976; 121: 20-32
        • Engh C.A.
        • Massin P.
        • Suthers K.E.
        Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components.
        Clin Orthop Relat Res. 1990; 25: 107-128
        • Takao M.
        • Ohzono K.
        • Nishii T.
        • Miki H.
        • Nakamura N.
        • Sugano N.
        Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia.
        J Bone Joint Surg Am. 2011; 93: 548-555
        • Lewinnek G.E.
        • Lewis J.L.
        • Tarr R.
        • Compere C.L.
        • Zimmerman J.R.
        Dislocations after total hip-replacement arthroplasties.
        J Bone Joint Surg Am. 1978; 60: 217-220
        • Wang D.
        • Li L.L.
        • Wang H.Y.
        • Pei F.X.
        • Zhou Z.K.
        Long-term results of cementless total hip arthroplasty with subtrochanteric shortening osteotomy in Crowe type IV developmental dysplasia.
        J Arthroplasty. 2017; 32: 1211-1219
        • Sun C.
        • Zhang Y.
        • Li L.T.
        • Ding H.
        • Guo T.
        • Zhao J.N.
        Long-term outcomes of total hip arthroplasty with transverse subtrochanteric shortening osteotomy and modular stem in Crowe IV developmental dysplasia.
        J Arthroplasty. 2021; 36: 630-635
        • Imbuldeniya A.M.
        • Walter W.L.
        • Zicat B.A.
        • Walter W.K.
        Cementless total hip replacement without femoral osteotomy in patients with severe developmental dysplasia of the hip: minimum 15-year clinical and radiological results.
        Bone Joint J. 2014; 96-b: 1449-1454
        • Hitz O.F.
        • Flecher X.
        • Parratte S.
        • Ollivier M.
        • Argenson J.N.
        Minimum 10-year outcome of one-stage total hip arthroplasty without subtrochanteric osteotomy using a cementless custom stem for Crowe III and IV hip dislocation.
        J Arthroplasty. 2018; 33: 2197-2202
        • Watts C.D.
        • Abdel M.P.
        • Hanssen A.D.
        • Pagnano M.W.
        Anatomic hip center decreases aseptic loosening rates after total hip arthroplasty with cement in patients with crowe type-ii dysplasia: a concise follow-up report at a mean of thirty-six years.
        J Bone Joint Surg Am. 2016; 98: 910-915
        • Nagoya S.
        • Kaya M.
        • Sasaki M.
        • Tateda K.
        • Kosukegawa I.
        • Yamashita T.
        Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip.
        J Bone Joint Surg Br. 2009; 91: 1142-1147
        • Eskelinen A.
        • Helenius I.
        • Remes V.
        • Ylinen P.
        • Tallroth K.
        • Paavilainen T.
        Cementless total hip arthroplasty in patients with high congenital hip dislocation.
        J Bone Joint Surg Am. 2006; 88: 80-91
        • Mu W.
        • Yang D.
        • Xu B.
        • Mamtimin A.
        • Guo W.
        • Cao L.
        Midterm outcome of cementless total hip arthroplasty in Crowe IV-Hartofilakidis Type III developmental dysplasia of the hip.
        J Arthroplasty. 2016; 31: 668-675
        • Ollivier M.
        • Abdel M.P.
        • Krych A.J.
        • Trousdale R.T.
        • Berry D.J.
        Long-term results of total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe IV developmental dysplasia.
        J Arthroplasty. 2016; 31: 1756-1760
        • Ding Z.C.
        • Zeng W.N.
        • Mou P.
        • Liang Z.M.
        • Wang D.
        • Zhou Z.K.
        Risk of dislocation after total hip arthroplasty in patients with crowe type iv developmental dysplasia of the hip.
        Orthop Surg. 2020; 12: 589-600
        • Gausden E.B.
        • Parhar H.S.
        • Popper J.E.
        • Sculco P.K.
        • Rush B.N.M.
        Risk factors for early dislocation following primary elective total hip arthroplasty.
        J Arthroplasty. 2008; 33: 1567-1571
        • Ollivier M.
        • Abdel M.P.
        • Krych A.J.
        • Trousdale R.T.
        • Berry D.J.
        Response to letter to the editor on "long-term results of total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe IV developmental dysplasia".
        J Arthroplasty. 2017; 32: 2621
        • Krych A.J.
        • Howard J.L.
        • Trousdale R.T.
        • Cabanela M.E.
        • Berry D.J.
        Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia: surgical technique.
        J Bone Joint Surg Am. 2010; 92: 176-187
        • Liu R.
        • Li Y.
        • Bai C.
        • Song Q.
        • Wang K.
        Effect of preoperative limb-length discrepancy on abductor strength after total hip arthroplasty in patients with developmental dysplasia of the hip.
        Arch Orthop Trauma Surg. 2014; 134: 113-119
        • Benedetti M.G.
        • Cavazzuti L.
        • Amabile M.
        • Tassinari E.
        • Valente G.
        • Zanotti G.
        • et al.
        Abductor muscle strengthening in THA patients operated with minimally-invasive anterolateral approach for developmental hip dysplasia.
        Hip Int. 2021; 31: 66-74
        • Ranawat C.S.
        • Dorr L.D.
        • Inglis A.E.
        Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis.
        J Bone Joint Surg Am. 1980; 62: 1059-1065