Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"title":"NiTi Alloys Exposure Alters miR-124 Expression in Physiological and Osteoarthritic Osteoblasts.","authors":"M. Štefančík, L. Válková, J. Veverková, A. Weiser, A. Dlouhý, L. Ryba, M. Pávková Goldbergová","doi":"10.55095/achot2022/059","DOIUrl":"https://doi.org/10.55095/achot2022/059","url":null,"abstract":"PURPOSE OF THE STUDY Nitinol (NiTi) is a biomaterial widely used in medicine based on super-elastic and shape memory properties. miR-124 has a key role in inflammatory process, osteoblasts differentiation, and mineralization. The aim of study was evaluating the differences in gene expression of miR-124 of human physiological osteoblasts (HOB) and human osteoarthritic osteoblasts (OSBA) as a response to NiTi alloy in different heat treatments. MATERIAL AND METHODS The cells were cultivated with NiTi discs with/without addition of bacterial lipopolysaccharide (LPS) for 72 hours. MicroRNAs were isolated, underwent reverse transcription and were analyzed by RT-PCR. RESULTS As a response to LPS, HOB overexpressed miR-124, while in OSBA expression change did not occur. Overexpression was also observed in both cell lines as a response to hydrogen and helium treated NiTi discs. HOB expressed significantly higher amount of miR-124 than OSBA as a response to hydrogen treatment of NiTi discs. In addition, hydrogen treatment caused significantly higher expression in HOB than LPS. The combination of NiTi disc and LPS treatment in HOB didn't cause any expression changes. Comparing to LPS-only treatment, the expression in HOB with combination of LPS and alloy was significantly lower. In OSBA, the expression was increased by the combination of LPS and hydrogen disc, in case of helium disc, the expression was decreased. CONCLUSIONS In conclusion, human physiological and osteoarthritic osteoblasts respond to NiTi alloy with both surface (hydrogen and helium atmosphere) treatment by overexpression of miR-124. The effect of LPS as inflammatory modulator suggests the presence of an \"anti-inflammatory preconditioning\" in osteoarthritic osteoblasts, as physiological osteoblasts overexpression was significantly higher. Key words: nitinol, osteoblast, miR-124, lipopolysaccharide.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 5 1","pages":"370-375"},"PeriodicalIF":0.4,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43484269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors and Treatment of Aseptic Pseudoarthrosis of the Humeral Shaft","authors":"V. POPELKA JR., V. Popelka","doi":"10.55095/achot2022/058","DOIUrl":"https://doi.org/10.55095/achot2022/058","url":null,"abstract":"","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43961917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mid-Term Results of Unicompartmental Knee Replacement Using Oxford Phase III System].","authors":"L. Nachtnebl, T. Tomáš, J. Rapi, J. Emmer, T. Valoušek","doi":"10.55095/achot2022/053","DOIUrl":"https://doi.org/10.55095/achot2022/053","url":null,"abstract":"PURPOSE OF THE STUDY Partial knee replacement appears to be an appropriate surgical solution of unicompartmental knee joint osteoarthritis in correctly indicated cases. The purpose of our study was to evaluate the mid-term outcomes of unicondylar knee replacement using the Oxford Phase III system in the group of patients treated by the First Department of Orthopaedic Surgery, St. Anne s University Hospital Brno. MATERIAL AND METHODS The prospective study evaluated 47 patients (in 4 patients bilaterally) after the Oxford unicompartmental knee replacement performed between 2011 and 2016. The patients were evaluated using the Knee Society Score (KSS), Oxford Knee Score (OKS) and radiological examination performed at 7.3 years after surgery on average. All the patients were operated on by the same surgeon. RESULTS Based on the questionnaires and the clinical examination, the clinical and functional status was assessed, using the Knee Society Score (KSS). The mean preoperative KSS and FS values were 59.8 and 56.5, respectively. The postoperative KSS and FS values were 91.2 and 83.4. The mean preoperative value of the Oxford Knee Score (OKS) was 27.3. Postoperatively the values reached 40.7 on average. Based on the radiological examination, the lower limb correction of axis in the frontal plane was assessed. The mean axis correction was 3.1°. The mean tibial component slope measured on lateral radiograph was 82.7°. The basic analysis of X-rays did not reveal any component malposition. The implant survival rate was calculated using the Kaplan-Meier cumulative survival curve. In our group of patients, the mean survival rate of Oxford Phase III unicondylar knee replacement at 7.3 years postoperatively is 98.0%. DISCUSSION Many studies have reported excellent results of unicondylar knee replacement and a long survival rate of over 90%. Still debated, however, are the indication criteria and also the importance of the surgeon s experience and mastery of the surgical technique. CONCLUSIONS The results of the study confirm our excellent clinical experience and the survival rate of 98% at the mean follow up of 7.3 years after surgery shows great promise for quality long-term results. Overall, crucial for the success of UKR continues to be the compliance with the indication criteria for surgery. The choice of the type of implant and, last but not least, the correct surgical technique and postoperative rehabilitation programme are also important. Key words: unicompartmental knee replacement, Oxford Phase III, osteoarthritis of the knee.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 5 1","pages":"332-338"},"PeriodicalIF":0.4,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45619614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clostridium difficile Colitis in Patients Undergoing Surgery for Adolescent Idiopathic Scoliosis.","authors":"A. Jurban, Y. Anekstein, Y. Mordish, O. Rabau, Y. Mirovsky, Y. Smorgick","doi":"10.55095/achot2022/060","DOIUrl":"https://doi.org/10.55095/achot2022/060","url":null,"abstract":"PURPOSE OF THE STUDY To identify risk factors associated with developing Clostridium difficile infection (CDI) in adolescent idiopathic scoliosis patients after surgery and to describe the clinical presentation of CDI in these patients. Clostridium difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on CDI rates and its consequences on patient undergoing surgery for adolescent idiopathic scoliosis. MATERIAL AND METHODS A retrospective database review of patients who underwent elective idiopathic scoliosis surgery between January 2019 to June 2021 was conducted. The population was divided into patients who developed Clostridium difficile colitis and those who did not. RESULTS A total of 128 patients were included in the study. We did not find notable risk factors for the development of CDI. In 2 patients diagnosis of CDI, was made. Length of hospital stays, and readmissions were significantly higher in patients with CDI. CONCLUSIONS CDI is a rare post-surgical complication in patients who undergo surgery for idiopathic scoliosis. Currently, we cannot identify predisposing factors for the development of CDI in adolescent idiopathic scoliosis patients. A high index of suspicion is necessary for timely diagnosis and treatment in patients presenting with abdominal symptoms around post-operative day 5 after surgical treatment for idiopathic scoliosis. Key words: Clostridium difficile infection, adolescent idiopathic scoliosis, abdominal pain, diarrhea.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 5 1","pages":"376-379"},"PeriodicalIF":0.4,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44817485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scapular Spine Fracture Defined on the Basis of a Bisphosphonate: a Case Report and Review of the Literature.","authors":"G. İlyas, G. Şenyuva","doi":"10.55095/achot2022/050","DOIUrl":"https://doi.org/10.55095/achot2022/050","url":null,"abstract":"Bisphosphonates are commonly used in the treatment of osteoporosis. Long-term use without drug holiday causes the risk of atypical fractures. Subtrochanteric and femoral stress fractures are among the frequently described complications. In our case report; a stress fracture of the scapular spine, a previously undescribed adverse effect of bisphosphonates, is presented. Key words: bisphosphonates, scapular spine, stress fracture, drug holiday.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 4 1","pages":"312-314"},"PeriodicalIF":0.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44738653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Analyses of Quadriceps Tendon Graft with Five Different Fixation Techniques on the Femoral Side: an Experimental Study on Sheep Knees.","authors":"M. Çeti N, M. S. Söylemez, B. Y. Öztürk, İ. Mutlu, Ö. Karakuş","doi":"10.55095/achot2022/047","DOIUrl":"https://doi.org/10.55095/achot2022/047","url":null,"abstract":"PURPOSE OF THE STUDY We aimed to evaluate the biomechanical properties of quadriceps tendon graft with a bone plug ending (QTBP) and a quadriceps graft with a tendinous ending(QTT) fixed on the femoral side with different fixation devices. MATERIAL AND METHODS Twenty-five paired 2-year-old calf QTs and 25 paired 2-year-old sheep femurs were used for this study. 90x8 mm central part of the quadriceps tendons with or without a bone plug was harvested. 8×25 mm tunnel was placed in lateral condyles. The QTT was fixed with four different fixation devices, including the adjustable suspensory system (QTT-ASS, group 1), biodegradable interference screws (QTT-BIS, group 2), titanium interference screws (QTT-TIS, group 3), and an adjustable suspensory system + biodegradable interference screws (QTT-(ASS+BIS), group 4); QTBP was fixed with titanium interference screws (QTBP-TIS, group 5). All groups were tested in a servohydraulic materials testing machine. Stiffness(N/mm), slippage of the tendon(mm), and the ultimate tensile load-bearing ability(N) of the groups were tested. The Kruskal-Wallis H test was used with the Monte Carlo simulation technique to compare the nonparametric variables of stiffness, slippage, and ultimate tensile load. Dunn's test was used for the post hoc analyses. RESULTS Group 3 had the stiffest fixation (median 45.09 N/mm). The amount of slippage was highest in group 1(median 6.41mm). Group 1 was the most resistant group against a tensile load during the load-to-failure test(464 N). Fixing the QTT with the ASS and BIS in group 4 increased both stiffness and ultimate tensile load strength. There was no significant difference between the QTBP and QTT fixed with titanium screws. Fixing QTT with titanium screws was significantly superior to fixation with BIS(p < 0.05). CONCLUSIONS This study demonstrates that QTBP fixation with TIS have no advantage over QTT fixation with TIS on the femoral side. Although the QTT group fixed with ASS was the most resistant group against tensile forces during load-to-failure test, amount of slippage was highest for this group as well. Thus, if an ASS is to be used, a strong tension force must be applied prior to tibial side fixation to prevent further slippage of the graft in the tunnel. Key words: anterior cruciate ligament, quadriceps tendon graft, femoral side, fixation, biomechanical properties.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 4 1","pages":"293-299"},"PeriodicalIF":0.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46653873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical Outcomes of the Application of Platelet-Rich Fibrin during Anatomic Anterior Cruciate Ligament Reconstruction: Results of Prospective Randomised Study].","authors":"J. Kasl, P. Zeman, T. Pavelka, J. Cibulková, J. Pilný, J. Matějka","doi":"10.55095/achot2022/045","DOIUrl":"https://doi.org/10.55095/achot2022/045","url":null,"abstract":"PURPOSE OF THE STUDY It was a prospective, randomised, unblinded study. Effects of the application of platelet-rich fibrin (PRF) on the anatomic anterior ligament reconstruction were examined. MATERIAL AND METHODS A total of 40 patients who underwent a surgery between 2012 and 2014 were enrolled in the study. The patients were randomised into two groups: the group with PRF application (n=20) and the group without PRF application (n=20, control group). The study included 11 women and 29 men, with the mean age at the time of inclusion into the study 29.1 years. Vivostat ® PRF was obtained perioperatively from the patient s blood and applied intraoperatively to the hamstring tendon graft. The ACL graft healing was assessed through magnetic resonance (MRI) at 6 and 12 months postoperatively. The clinical outcomes (the Lysholm score and the IKDC Subjective score, return to pre-injury sport levels, Pivot-shift test, graft failure) as well as standardised laxity measurements using GenouRob arthrometer were performed preoperatively and 12 months after surgery. RESULTS The study was completed by thirty-three (33) patients (17 in the PRF group and 16 in the control group). In two cases, postoperative graft failure was reported (both cases in the control group). No significant differences were found in the process of graft ligamentization evaluated through MRI (p=0.07). No significant difference between the groups was identified with respect to return to pre-injury sport levels (p=0.232), or the Lysholm score and IKDC Subjective score (p=0.259, and p=0.364 respectively). The postoperative knee laxity measurement using Genourob arthrometer did not reveal any significant differences between the PRF group and the control group. DISCUSSION Results similar to those arrived at by our study have recently been published also by other authors worldwide. We can therefore assume that the application of PRF can be of benefit, especially at the early stage of healing. The results still need to be verified on a larger study group, the study design should focus on the development in the early postoperative period. CONCLUSIONS In our study group, no significant difference was observed in the evaluated subjective and objective clinical parameters. Only the parameter regarding the ACL graft failure fell just short of statistical significance, namely to the disadvantage of the group without the PRF application. Key words: anterior cruciate ligament, arthroscopy, anatomic ACL reconstruction, magnetic resonance imaging of the graft, platelet-rich fibrin, graft healing, MRI signal intensity of the graft.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 4 1","pages":"279-285"},"PeriodicalIF":0.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44775484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intramedullary Nailing in Managing Diaphyseal Metastases of Long Bones: Retrospective Study Comparing the Expected Survival and the Actual Survival of Patients].","authors":"T. Valoušek, L. Pazourek, T. Tomáš, M. Mahdal, P. Janícek, V. Apostolopoulos","doi":"10.55095/achot2022/043","DOIUrl":"https://doi.org/10.55095/achot2022/043","url":null,"abstract":"PURPOSE OF THE STUDY The paper focuses on the potential use of nail osteosynthesis in diaphyseal metastases of long bones. The purpose of the paper is to assess the outcomes of intramedullary osteosynthesis in pathologic and impending pathologic fractures, to evaluate patient survival and potential complications. MATERIAL AND METHODS The retrospective study evaluated a cohort of 42 patients (19 men and 23 women) in whom intramedullary osteosynthesis was performed for complete pathologic fracture (28 patients) or impending pathologic fracture (14 patients) between 2010 and 2019. Of the total number of 42 patients, 31 patients' lower limbs were affected, namely by 17 pathologic fractures and 14 impending fractures. There were 11 humerus fractures. The mean age was 61.8 years (range 41-84 years). In the followed-up cohort, the patient survival after osteosynthesis with intramedullary nails, complications occurred and post-operative mobility of the patient were assessed. The functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system. The unpaired Mann-Whitney test was used to test the significance of the difference in functional outcomes and survival between the followed-up groups. Survival longer than 6 months was evaluated using Fisher's exact test. The level of statistical significance used for the test was p 0.05. RESULTS The investigated indicator was patient survival, which was 11.3 months (range 1-50 months) on average. In the group of impending fractures, the mean survival was 13.5 months. In the group of pathologic fractures, the survival was 10 months. The functional outcome in 16 followed-up patients at three months after intramedullary osteosynthesis according to the MSTS score was 46.9% (30-66.7%). At the level of significance of p 0.05, the statistically significant difference in the functional outcomes between the group with preventive intramedullary osteosynthesis and the group with nail osteosynthesis of the pathologic fracture was not confirmed (p=0.952). When comparing the patient survival after nail osteosynthesis with impending pathologic fracture and the survival of patients with pathologic fracture, a statistically significant difference in survival between these two groups (p=0.520) was not confirmed. The patient survival of longer than 6 months was 71% in the group of impending fractures and 40% in the group of pathologic fractures. DISCUSSION The occurrence of pathologic fracture is associated with increased pain, loss of function, and according to some authors, a higher risk of death. Surgical treatment options include intramedullary osteosynthesis, plate osteosynthesis with cement filling, implantation of an intercalary spacer, and implantation of tumor endoprostheses. When deciding on a surgical procedure, an account is taken of the expected survival of the patient. In patients with an expected survival of up to 6 months, intramedullary osteosynthesis is indicated as a palliative surg","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 4 1","pages":"266-271"},"PeriodicalIF":0.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42307106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Bone Fractures in the Hand in Adult Population Using the ICD-10 Classification.","authors":"D. Domínguez-Prado, L. Ferradas-Garcia, E. Pérez-Alfonso, P. Balvís-Balvís, J. A. Lopez-Lopez, M. Castro-Menéndez","doi":"10.55095/achot2022/041","DOIUrl":"https://doi.org/10.55095/achot2022/041","url":null,"abstract":"PURPOSE OF THE STUDY The purpose of this study was to conduct an epidemiological study of hand fractures in adult population. MATERIAL AND METHODS A retrospective observational study in a population of 470,000 habitants was performed. Over the course of three years, all patients over 16 years of age who were diagnosed with fracture or fracture-dislocation at the level of a carpal bone, metacarpal and/or phalange were included. These fractures were classified according to the International Classification of Diseases 10th edition (ICD-10). Incidence rates, along with gender and age distribution were also studied. RESULTS 1,267 patients with a total of 1,341 hand fractures were included. They represented 29.7% of all upper limb fractures and 7.6% of all traumatological emergencies involving a bone fracture during that period. The most frequent ICD-10 group was S62.3, with the fifth metacarpal as the most often affected bone (39.7%). The most frequent location at the level of the phalanges (S62.5) was the proximal third of the proximal phalanx of the fifth radius. The global incidence rate was 99 fractures per 100,000 persons/year. No seasonal variation was observed. Only 10.2% of hand fractures received surgical treatment. DISCUSSION Several epidemiological studies have been published on fractures in the hand, but none have used the ICD-10 classification. Although the distribution of our stratified sample by age and gender was similar to those previously published, the incidence rate in our study was much lower. We may possibly extrapolate our results to the rest of the Spanish population and even to the rest of the population of southern Europe, given the scarcity of epidemiological studies on this matter in these geographical areas. CONCLUSIONS The ICD-10 classification is useful for the description and classification of hand fractures. The most often affected group is that including metacarpals of the long fingers (S62.3), being the distal level of the fifth metacarpal in young male patients the most frequent one. Most fractures are treated conservatively and in case of surgical treatment, the preferred surgical techniques include K-wire fixation, interfragmentary compression screws and plate osteosynthesis. Key words: epidemiology, incidence, fracture, fracture dislocation, carpal bones, metacarpals, finger phalanges.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 4 1","pages":"252-259"},"PeriodicalIF":0.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43073317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of High Hip Center versus Anatomical Reconstruction Technique in Crowe Types II and III Developmental Dysplasia of the Hip: a Retrospective Clinical Study.","authors":"M. Demirel, A. Kendirci, Y. Sağlam, O. N. Ergin, C. Sen, I. Öztürk","doi":"10.55095/achot2022/044","DOIUrl":"https://doi.org/10.55095/achot2022/044","url":null,"abstract":"PURPOSE OF THE STUDY The literature is conflicting as to whether the high hip center (HHC) reconstruction in total hip arthroplasty (THA) is an ideal option for patients with severe developmental dysplasia of the hip (DDH). This study aimed to compare the mid-term functional and radiographic outcomes of THA using HHC versus anatomical hip center (AHC) technique in Crowe types II and III DDH. Our hypothesis was that there may be no differences in terms of functional and radiographic outcomes between patients who underwent THA using HHC or AHC. MATERIAL AND METHODS Fifty-seven patients who underwent a primary THA due to Crowe type-II or type-III DDH were retrospectively reviewed and included. Patients were divided into two groups as per the hip center reconstruction: Group A (AHC technique) and group H (HHC technique). A cementless cup was inserted in 25 hips (19 female, 6 male; mean age = 51 years, age range = 28-67)) at near-AHC in group A and 32 hips (22 female, 10 male; mean age = 53 years, age range = 29-68) at HHC position in group H. To assess clinical status, the Harris Hip Score (HHS) was used at the final follow-up. In radiographical assessment, component loosening and osseointegration of the acetabular cup were examined on follow-up radiographs. Complications were also recorded. RESULTS The mean follow-up was 41 months (range, 25-84) in group A and 40 months (range, 24-86) in group H. The mean HHS was 83 (range, 74-91) in group A and 83.6 (range, 73-94) in group H (p = 0.741). Osteolysis was determined in three patients from each group. The other 51 cups demonstrated a minimum of one radiographic sign of osseointegration. Although the overall complication rate was higher in group A (64%) than in group H (46%), this difference reached no statistical significance (p = 0.11). CONCLUSIONS The HHC technique using cementless acetabular fixation seems to be a valuable alternative option to AHC technique in cases of Crowe types II and III DDH. Key words: High hip center; anatomical hip center; center of rotation; total hip arthroplasty; dysplastic hip; developmental dysplasia of the hip; Crowe type II; Crowe Type III.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"89 4 1","pages":"272-278"},"PeriodicalIF":0.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47554233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}