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Long-Term Results of Cemented Total Hip Arthroplasty in Developmental Dysplasia With Acetabular Bulk Bone Grafts After Improving Operative Techniques
Authors:Haruhiko Akiyama  Keiichi Kawanabe  Hirokazu Iida  Pan Haile  Koji Goto  Takashi Nakamura
Institution:? Department of Orthopedic Surgery, Kyoto University, Kyoto, Japan; Department of Orthopedic Surgery, Kansai Medical University, Osaka, Japan
Abstract:We present the long-term results (mean follow-up, 11.8 years; range, 6.3-15.4 years) of cemented total hip arthroplasty with acetabular bulk bone grafting in 147 dysplastic hips using improved surgical techniques. Operations were performed through a direct lateral approach with partial trochanteric osteotomy to avoid nonunion of the greater trochanter. Bioresorbable poly(l-lactide) screws were used for fixation of the acetabular bone grafts to prevent any possible delayed remodeling. Preoperative planning using computer simulation was performed to estimate the optimal size and position of the acetabular component. Analysis predicted rates of survival of the acetabular component of 96% and 91% at 15 years, with revision for aseptic loosening and radiologic loosening as the end points, respectively. Our results indicate excellent long-term clinical and radiographic survivorship of a cemented acetabular component with bulk autograft for acetabular dysplasia.
Keywords:total hip arthroplasty  long-term results  acetabular autogenous bulk bone graft  improved operative techniques
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