Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Is Restoration of Hip Center Mandatory for Total Hip Arthroplasty of Protrusio Acetabuli?

  • Beom Seok Lee (Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital) ;
  • Hong Seok Kim (Department of Orthopaedic Surgery, Seoul National University Hospital) ;
  • O Sang Kwon (Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital) ;
  • Young-Kyun Lee (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital) ;
  • Yong-Chan Ha (Department of Orthopaedic Surgery, Chung-Ang University College of Medicine) ;
  • Kyung-Hoi Koo (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital)
  • Received : 2021.09.23
  • Accepted : 2022.03.14
  • Published : 2022.06.30
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Abstract

Purpose: While initial fixation using a press-fit of the acetabular cup is critical for the durability of the component, restoration of the hip center is regarded as an attributable factor for implant survival and successful outcome. In protrusio acetabuli (PA), obtaining both restoration of the hip center and the press-fit of the acetabular cup simultaneously might be difficult during total hip arthroplasty (THA). We tested the hypothesis that use of a medialized cup, if press-fitted, will not result in compromise of the implant stability and outcome after cementless THA of PA. Materials and Methods: A total of 26 cementless THAs of 22 patients with PA were reviewed. During THA, press-fit of the cup was prioritized rather than hip center restoration. A press-fit was obtained in 24 hips. A pressfit could not be obtained in the two remaining hips; therefore, reinforcement acetabular components were used. Restoration of the hip center was achieved in 17 cups; 15 primary cups and two reinforcement components; it was medialized in nine cups. Implant stability and modified Harris hip score (mHHS) between the two groups were compared at a mean follow-up of 5.1 years (range, 2-16 years). Results: Twenty-six cups; 17 restored cups and nine medialized press-fitted cups, remained stable at the latest follow-up. A similar final mHHS was observed between the restored group and the medialized group (83.6±12.1 vs 83.8±10.4, P=0.786). Conclusion: Implant stability and favorable results were obtained by press-fitted cups, irrespective of hip center restoration. THA in PA patients showed promising clinical and radiological results.

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References

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