Developmental dysplasia of the hip (DDH) is a major cause of hip arthritis and ultimately total hip arthroplasty. Due to the dysplastic acetabulum, how to place the acetabular cup becomes a challenge in acetabular reconstruction for such patients. Especially in the acetabula classified as Crowe typeⅡand type Ⅲ, the dislocation of the femoral head causes bone defects above the true acetabulum, which will affect the stability of the acetabular cup when the acetabular reconstruction is performed at the true acetabulum. Many acetabular reconstruction methods such as bone grafting, the use of small acetabular cups, socket medialization technique, and high hip center technique are used to increase the host bone coverage of the cup. However, each method has its own shortcomings that can not be ignored so that there is no unified conclusion on the acetabular reconstruction methods for Crowe typeⅡand type Ⅲ hip dysplasia. This article summarized and evaluated various reconstruction methods in combination with the acetabular morphology of DDH, and put forward the research direction in the future.
Acetabulum/surgery* ; Arthroplasty, Replacement, Hip ; Developmental Dysplasia of the Hip ; Hip Dislocation/surgery* ; Hip Dislocation, Congenital/surgery* ; Hip Prosthesis ; Humans ; Treatment Outcome

Adult ; Female ; Hip Dislocation ; diagnosis ; surgery ; Humans

Arthroplasty, Replacement, Hip ; Hip Dislocation, Congenital ; surgery ; Humans

The selection of the prosthetic material determine the success or failure of hip arthroplasty. Currently, the metals, ceramics, polymer composites and carbon materials are the main prosthetic materials of artificial hip joint. They have some progresses in biocompatibility, elastic modulus,mechanical properties, useful life, but they still can't reach the ideal standard of design. In this essay, we mainly review the characteristics and applications of the current artificial hip joint materials through its classification in order to provide a reference for choosing appropriate hip joint materials in clinic and increasing characteristic of materials. We consider the polymer composites has more advantages such as biocompatibility, mechanical properties, corrosion resistance and price, even if it has shortages in abrasion resistance. As the researches of polymer composites are main focus on abrasion resistance, articular surface and strength,and its performances are increased fast, it has a wide prospect in future.
Animals ; Hip Dislocation ; surgery ; Hip Prosthesis ; standards ; utilization ; Humans

Fracture Fixation, Internal ; Hip Dislocation ; surgery ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Humans ; Male ; Young Adult

This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture-dislocations of the left hip (Pipkin's type IV) and knee (Moore II) joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.
Adult ; Fractures, Open ; surgery ; Hip Dislocation ; surgery ; Humans ; Knee Dislocation ; surgery ; Leg Injuries ; surgery ; Male ; Tomography, X-Ray Computed

OBJECTIVE: To investigate how to place the anteversion of acetabular prosthesis more reasonably in patients with lumbar degenerative kyphosis. METHODS: A total of 122 patients with degenerative kyphosis of lumbar spine who underwent total hip arthroplasty from December 2017 to October 2019 were included and divided into experimental group and control group, 61 cases in each group. In experimental group, there were 25 males and 36 females, with a median age of 67.0 years;the median course of disease was 46.0 months;the functional pelvic plane with acetabular anteversion was set according to different types of pelvic anterior plane bracket. In control group, there were 27 males and 34 females, with a median age of 67.0 years;the median course was 42.0 months;in control group, the anteversion was set by the traditional method. The patients were followed up for 3 months. The operation time and blood loss were recorded. The incidence of infection and dislocation within 3 months was counted. Harris score before and 3 months after operation was recorded. Functional anteversion angle of standing position was measured 3 months after operation. RESULTS: Compared with control group, there was no difference in operation time and blood loss between the two groups (P=0.918, 0.381);there was no infection between two groups within 3 months after operation;there was 1 case of hip joint dislocation in the control group and no dislocation in experimental group. There was no significant difference in Harris score before and after operation. Three months later, reexamination of pelvic standing radiographs showed that the number of patients with functional anteversion of acetabular prosthesis outside the safe area was less in experimental group thanin control group ( CONCLUSION According to the preoperative evaluation and classification of patients, better functional anteversion of acetabular prosthesis can be obtained with the help of pelvic anterior plane reference bracket in hip arthroplasty with lumbar degenerative kyphosis.
Acetabulum/surgery* ; Aged ; Arthroplasty, Replacement, Hip ; Female ; Hip Dislocation/surgery* ; Hip Joint ; Hip Prosthesis ; Humans ; Kyphosis ; Male ; Retrospective Studies

Arthroplasty, Replacement, Hip ; Bone Transplantation ; Femur ; surgery ; Hip Dislocation, Congenital ; diagnosis ; surgery ; Humans

OBJECTIVETo investigate the effects of periacetabular osteotomy (PAO) for developmental dysplasia of the hip in adolescent.

METHODSTwelve hips in 9 adolescent patients who underwent a Bernese periacetabular osteotomy for symptomatic or asymptomatic developmental dysplasia of the hip were analyzed. The average age of the patients at the time of surgery was 12.9 years(11-14 years). The Harris hip score and overall patient satisfaction with surgery were used to assess hip function and clinical results. Plain radiographs were used to assess the correction of the deformity and to observe progression of degenerative changes.

RESULTSThe average duration of clinical follow-up was 88.5 (60-136) months. The mean Harris hip score increased from 89 ± 6 preoperatively to 97 ± 3 at the time of the most recent follow-up (t = -6.754, P = 0.000). All patients (12 hips) had an excellent clinical result. The lateral center-edge angle of Wiberg increased from 4° ± 13° preoperatively to 36° ± 7° at the time of the most recent follow-up (t = -11.677, P = 0.000). The acetabular roof obliquity decreased from 28° ± 10° preoperatively to 2° ± 8° at the time of the most recent follow-up (t = 9.038, P = 0.000). The acetabular-head index increased from 54% ± 11% preoperatively to 89% ± 13% at the time of the most recent follow-up (t = -11.137, P = 0.000). The hip center was translated medially. Improvement of cystic degeneration of the acetabulum were found in 4 hips. Remodeling of aspherical uncongruence were found in 5 cases. Crossing sign were found in 2 hips postoperatively without symptoms of impingement.

CONCLUSIONSPAO can provide comprehensive deformity correction and improve hip function in treatment of developmental dysplasia of the hip in adolescence. Some of the patients have improvement of cystic degeneration and remodeling of the hip.

Acetabulum ; pathology ; Adolescent ; Child, Preschool ; Disease Progression ; Hip Dislocation ; surgery ; Hip Dislocation, Congenital ; Humans ; Osteotomy ; Postoperative Period

OBJECTIVE: To provide guidance for hip replacement by analyzing the variation of femoral head rotation center in different hip diseases. METHODS: A total of 5 459 patients were collected from March 2016 to June 2021, who took positive and proportional plain films of both hips for various reasons. The relative position between the rotation center of the femoral head and the apex of the greater trochanter was measured. The positive variation is more than 2 mm above the top of the great trochanter, and the negative variation is more than 2 mm below the top of the great trochanter. A total of 831 patients with variation of femoral head rotation center were collected and were divided into 4 groups according to different diseases, and the variation was counted respectively. There were 15 cases in the normal group involving 10 cases of positive variation and 5 cases of negative variation. There were 145 cases of avascular necrosis of femoral head involving 25 cases of positive variation and 120 cases of negative variation. There were 346 cases of congenital hip dysplasia involving 225 cases of positive variation(including 25 cases of typeⅠ, 70 cases of type Ⅱ, 115 cases of type Ⅲ and 15 cases of type Ⅳ), and 121 cases of negative variation(including 50 cases of crowe typeⅠ, 60 cases of typeⅡ, 10 cases of type Ⅲ and 1 case of type Ⅳ). There were 325 cases of hip osteoarthritis group involving 45 cases of positive variation and 280 cases of negative variation. RESULTS: There was significant difference in variation of femoral head rotation center among the four groups(P<0.05). There was significant difference in variation of femoral head rotation center among different types of congenital hip dysplasia(P<0.05). There were significant differences in cervical trunk angle and eccentricity among different variations of femoral head rotation center(P<0.05). CONCLUSION The variation of femoral head rotation center is related to cervical trunk angle and eccentricity. The variation of femoral head rotation center is an important factor in hip diseases. The variation of femoral head rotation center is different in different hip diseases. Avascular necrosis of the femoral head and osteoarthritis of the hip were mostly negative variations. With the aggravation of congenital hip dysplasia, the variation of femoral head rotation center gradually changed from negative variation to positive variation.The variation of femoral head rotation center should be paid attention to in the preoperative planning of hip arthroplasty. It is of great significance to select the appropriate prosthesis and place the prosthesis accurately.
Humans ; Femur Head/surgery* ; Hip Dislocation, Congenital/surgery* ; Hip Prosthesis ; Arthroplasty, Replacement, Hip/methods* ; Femur/surgery* ; Retrospective Studies ; Treatment Outcome