First application of three-dimensional designing total hip arthroplasty with long uncemented stem for fibrous dysplasia patients combined with hip joint osteoarthritis

BMC Musculoskeletal Disorders

Li Min¹  Yong Zhou¹  Jie Wang¹  Fan Tang¹  Wenli Zhang¹  Minxun Lu¹  Yi Luo¹  Yuqi Zhang¹  Chongqi Tu¹  Kai Yao¹ 

[1] 0000 0004 1770 1022, grid.412901.f, Department of Orthopedics, West China Hospital, Sichuan University, Guoxue Xiang No. 37, 610041, Chengdu, Sichuan, People’s Republic of China;

关键词: Fibrous dysplasia;    Osteoarthritis;    3D designing;    Total hip arthroplasty;    Long uncemented stem;   

DOI  :  10.1186/s12891-019-2608-y

来源: publisher

【 摘 要 】

BackgroundIn order to treat proximal femur fibrous dysplasia (FD) patients combined with hip joint osteoarthritis (OA), the three-dimensional (3D) designing osteotomy and implantation of femoral component was firstly used for deformity correction and total hip arthroplasty (THA). The purpose is to present the detailed design, perioperative management and evaluate short-term clinical outcomes of this novel therapeutic method.MethodA retrospective study was performed in twelve FD patients combined with hip joint OA who were treated in our hospital between July 2013 and April 2015. Seven patients received 3D designing combined osteotomy and THA, and the other five patients underwent 3D designing THA only.ResultsAll patients were followed-up with an average duration of 47 months (range, 35–56 months). There was no infection, dislocation, postoperative wound problems or mechanical failures. For the seven patients receiving 3D designing corrective osteotomy, the mean extremity lengthening was 2.8 (range, 1.5–4) cm. The average duration of bone union was 4.2 months. The average Harris Hip Score was improved from 46.08 (range, 13–67) points preoperatively to 93.72 (range, 83–100) points at the last follow-up. The average modified criteria of Guille was improved from 3.2 (range, 1–7) points preoperatively to 8.6 (range, 6–10) points at the last follow-up.ConclusionsThe 3D designing THA with long uncemented stem, including 3D designing corrective osteotomy and implantation of long prosthesis stem, seems to be a reliable method for FD patients combined with hip joint OA. Through preoperative 3D design, corrective osteotomy and implantation of long prosthesis stem can be precise to re-store alignment, uttermost preserve host bone, obtain primary stem stability and provide necessary condition for long-term stem survival, finally leading to better limb function. Besides, perioperative management should be abided strictly for late stability. Nevertheless, the outcomes of long-term follow-up and larger cases are still required.

【 授权许可】

CC BY