Total hip arthroplasty with shelf acetabuloplasty in dysplastic coxarthrosis, mean follow-up of 7 years.

UNLABELLED: Developmental dysplasia of the hip (DDH) is the cause of approximately one third of secondary coxarthrosis. Anatomy alterations make it difficult to place a total hip prosthesis in its anatomical position and for it to be stable in the long term; there are several techniques to achieve this goal. In the present work we used autograft of the femoral head (shelf graft or reinforced roof), to improve the coverage of the acetabular component with favorable results.

MATERIALS AND METHODS: 16 cases were included in 14 patients with a diagnosis of DDC (13 women and 1 man), the mean age was 44.3 years (range 35 to 68 years), with a mean follow-up of 7 years (range 1 to 15 years). All the cases were evaluated clinically and radiographically, to demonstrate the osseointegration of the graft and the functional results in the medium term.

RESULTS: All the acetabular components were placed in anatomical position (Ranawat technique), the mean percentage of host bone coverage was 54.53% (range 43.28% to 79.05%), obtaining additional coverage with the bone graft of 45.13%. Osseointegration of the graft of 100% at 12 weeks, resorption of the graft from the sixth month, stabilizing in the third postoperative year. Only one case of dislocation is reported, no cases of infection, loosening, heterotopic ossification or revision.

CONCLUSION: This procedure has shown good functional results in the medium term with 100% osseointegration, despite cases of severe bone resorption of the graft that does not compromise the stability of the prosthesis.

EVIDENCE LEVEL: III. Retrospective study.