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Hybrid total hip arthroplasty for multiple epiphyseal dysplasia - 24/04/18

Doi : 10.1016/j.otsr.2017.11.014 
J. Vanlommel a, , L. Vanlommel b, B. Molenaers b, J.-P. Simon b
a Orthoclinic, AZ Sint Lucas Brugge, Sint Lucaslaan 29, 8310, Brugge Belgium 
b UZ Pellenberg, department of Orthopaedics, Weligerveld 1, Leuven, Belgium 

Corresponding author.

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Abstract

Background

Multiple Ephiphyseal Dysplasia (MED) is a rare autosomal dominant skeletal dysplasia that causes deformation of the epiphysis of the involved joints. The hips are invariably affected and symptoms due to incapacitating early onset degenerative hip disease often begin between the second and fourth decade of life. Literature regarding the clinical and radiographical outcomes after total hip arthroplasty in this young population are very scarce.

Hypothesis in patients with multiple epiphyseal dysplasia and early onset degenerative hip disease, hybrid total hip arthroplasty is a safe and reliable procedure.

Patients and methods

We followed 10 hybrid total hip arthroplasties in 6 patients with respect to the early and medium term complications. The average age at surgery was 32 years old (17 to 41). All stems were cemented polished straight tapered stems, all cups were porous coated uncemented cups. The mean duration of follow-up was 10.3 (7–14, SD2.8) years. Clinical outcomes were measured using the Charnley modification of the Merle d’Aubigné-Postel grading system and VAS-scores.

Results

No early complications and no revisions occurred and patients significantly improved for pain, function and mobility. The Charnley, Merle d’Aubigné and Postel hip scores significantly improved from 9.6 points pre-operatively (range: 8–11 points) to 17 points (range: 16–18 points) and the VAS-score significantly improved after surgery from respectively 7 at rest and 8.5 during activity preoperatively to 1 at rest and 1.5 during activity postoperatively. Radiographic evaluation showed no cases of radiolucency around the cemented femoral components. No migration or subsidence of the components was noted. With regard to the acetabular component, osteolysis was noted in 4 hips, but serial radiographs showed no progression or migration of the component and the patients were completely pain free.

Conclusion

Hybrid total hip arthroplasty is a viable treatment option in multiple epiphyseal dysplasia patients, with excellent mid-term clinical and radiographical outcomes.

Level of evidence

Level IV, retrospective study.

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Keywords : Total hip arthroplasty, Hip dysplasia, Multiple ephiphyseal dysplasia


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Vol 104 - N° 3

P. 301-305 - mai 2018 Regresar al número
Artículo precedente Artículo precedente
  • Hip resurfacing before 50 years of age: A prospective study of 979 hips with a mean follow-up of 5.1 years
  • J. Girard, A. Lons, N. Ramdane, S. Putman
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  • Do screws and screw holes affect osteolysis in cementless cups using highly crosslinked polyethylene? A 7 to 10-year follow-up case–control study
  • N. Taniguchi, T. Jinno, R. Takada, D. Koga, T. Ando, A. Okawa, H. Haro

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