Our study reports a sub-group of patients with developmental dysplasia from a previously published larger series, with particular emphasis on the use of the uncemented RM acetabular component. We evaluated the long term results of 93 consecutive uncemented THAs in 80 patients using the titanium-coated RM acetabular component and the CLS femoral component in a prospective study. Eighteen hips in 16 patients had osteoarthritis secondary to developmental dysplasia of the hip. The mean follow-up was 19.6 years (18.2 to 20.9). Fourteen patients with 15 hips were clinically and radiographically examined and evaluated. Two patients with 3 hips died. No patient was lost to follow-up. No implant had to be revised, and no cases showed evidence of radiographic loosening. Nine acetabular components were not completely covered by host bone but this did not affect the outcome. At the latest follow-up the mean Harris Hip Score was 92 (81 to 100). The mean annual wear rate was 0.12 mm.
The RM acetabular component performed well over 20 years in this selected group of patients. Complete acetabular containment was not needed, thus allowing reliable reconstruction of the anatomical centre of rotation.
IhleM., MaiS., SiebertW.. The results of the titanium-coated RM acetabular component at 20 years. A long-term follow-up of an uncemented primary total hip replacement.J Bone Joint Surg Br2008; 90: 1284–90.
2.
CroweJ.F., ManiV.J., RanawatC.S.. Total hip replacement in congenital dislocation and dysplasia of the hip.J Bone Joint Surg Am1979; 61: 15–23.
3.
HartofilakidisG., StamosK., IoannidisT.T.. Low friction arthroplasty for old untreated congenital dislocation of the hip.J Bone Joint Surg Br1988; 70: 182–6.
4.
DorrL.D., TawakkolS., MoorthyM., LongW., WanZ.. Medial protrusio technique for placement of a porous-coated hemispherical acetabular component without cement in a total hip arthroplasty in patients who have acetabular dysplasia.J Bone Joint Surg Am1999; 81: 83–92.
5.
HartofilakidisG., StamosK., KarachaliosT., IoannidisT.T., ZacharakisN.. Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty.J Bone Joint Surg Am1996; 78: 683–92.
6.
McQuearyF.G., JohnstonR.C.. Coxarthrosis after congenital dysplasia. Treatment by total hip arthroplasty without acetabular bone grafting.J Bone Joint Surg Am1988; 70: 1140–4.
7.
PagnanoW., HanssenA.D., LewallenD.G., ShaughnessyW.J.. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty.J Bone Joint Surg Am1996; 78: 1004–14.
8.
RusottiG.M., HarrisW.H.. Proximal placement of the acetabular component in total hip arthroplasty. A long-term follow-up study.J Bone Joint Surg Am1991; 73: 587–92.
9.
BarrackR.L., NewlandC.C.. Uncemented total hip arthroplasty with superior acetabular deficiency. Femoral head autograft technique and early clinical results.J Arthroplasty1990; 5: 159–67.
10.
ShinarA.A., HarrisW.H.. Bulk structural autogenous grafts and allografts for reconstruction of the Acetabulum in total hip arthroplasty. Sixteen-year-average follow-up.J Bone Joint Surg Am1997; 79: 159–68.
11.
InaoS., MatsunoT.. Cemented total hip arthroplasty with autogenous grafting in for hips with developmental dysplasia in adults: the results at a minimum of ten years.J Bone Joint Surg Br2000; 82: 375–7.
12.
HamptonB.J., HarrisW.H.. Primary cementless acetabular components in hips with severe developmental dysplasia or total dislocation.J Bone Joint Surg Am2006; 88: 1549–52.
13.
MulroyR.D., HarrisW.H.. Failure of acetabular autogenous grafts in total hip arthroplasty: increasing incidence.J Bone Joint Surg Am1990; 72: 1536–40.
14.
HendrichC., MehlingI., SauerU., KirschnerS., MartellJ.M.. Cementless acetabular reconstruction and structural bone-grafting in dysplastic hips.J Bone Joint Surg Am2006; 88: 387–94.
15.
RozkydalZ., JanicekP., SmidZ.. Total hip replacement with CLS Expansion shell and a structural femoral head autograft for patients with congenital hip disease.J Bone Joint Surg Am2005; 87: 801–7.
16.
SpangehlM.J., BerryD.J., TrousdaleR.T., CabanelaM.E.. Uncemented acetabular components with bulk femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip. Results at five to twelve years.J Bone Joint Surg Am2001; 81: 1484–9.
17.
GasserB.. Biomechanical principles and studies. In: HorneG., ed. Hip-Joint Surgery. The RM Cup – Long-term experience with an elastic monobloc acetabular implant. Hamburg: Eichborn-Presse Verlag2008; 16–22.
18.
BauerR.F., KerschbaumerF., PoiselS., OberthalerW.. The transgluteal approach to the hip joint.Arch Orthop Trauma1979; 95: 47–9.
19.
Merle d'AubignéR., PostelM.. Functional results of hip arthroplasty with acrylic prosthesis.J Bone Joint Surg Am1954; 36: 451–75.
20.
HarrisW.H.. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end result study using a new method of result evaluation.J Bone Joint Surg Am1969; 51: 737–55.
21.
SharpI.K.. Acetabular dysplasia: the acetabular angle.J Bone Joint Surg Br1961; 43: 268–72.
22.
RanawatC.S., DorrL.D., InglisA.E.. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis.J Bone Joint Surg Am1980; 62: 1059–65.
23.
MassinP., SchmidtL., EnghC.A.. Evaluation of cementless acetabular component migration. An experimental study.J Arthroplasty1989; 4: 245–51.
24.
ScheierH., SandelJ.. Wear affecting the plastic cup in metal-plastic endoprostheses. In: GschwendN., DebrunnerH.U. eds. Total hip prosthesis.Baltimore: Williams and Wilkins1976; 186–90.
25.
DeLeeJ.G., CharnleyJ.. Radiological demarcation of cemented sockets in total hip replacement.Clin Orthop Relat Res1976; 121: 20–32.
BrookerA.F., BowermanJ.W., RobinsonR.A., RileyL.H.. Ectopic ossification following total hip replacement. Incidence and a method of classification.J Bone Joint Surg Am1973; 55: 1629–32.
28.
KimY.H., KimJ.S.. Total hip arthroplasty in adult patients who had developmental dysplasia of the hip.J Arthroplasty2005; 20: 1029–36.
29.
ChougleA., HemmadyM.V., HodgkinsonJ.P.. Severity of hip dysplasia and loosening of the socket in cemented total hip replacement.J Bone Joint Surg Br2005; 87: 16–20.
30.
JastyM., AndersonM.J., HarrisW.H.. Total hip replacement for developmental dysplasia of the hip.Clin Orthop Relat Res1995; 311: 40–5.
31.
LeeB.P., CabanelaM.E., WallrichsS.L., IlstrupD.M.. Bone-graft augmentation for acetabular deficiencies in total hip arthroplasty. Results of long-term follow-up evaluation.J Arthroplasty1997; 12: 503–10.
32.
LewinnekG.E., LewisJ.L., TarrR., CompereC.L., ZimmermannJ.R.. Dislocation after total hip replacement arthroplasties.J Bone Joint Surg Am1978; 60: 217–20.
33.
PatilS., BergulaA., ChenP.C., ColwellC.W., D'LimaD.D.. Polyethylene wear and acetabular component orientation.J Bone Joint Surg Am2003; 85(Suppl 4): 56–63.
34.
CrowtherJ.D., LachiewiczP.F.. Survival and polyethylene wear of porous-coated acetabular components in patients less than fifty years old. Results at nine to fourteen years.J Bone Joint Surg Am2002; 84: 729–35.
35.
WillertH.G.. Tissue reactions to metallic and plastic wear products of joint endoprostheses. In: GschwendN., DebrunnerH.U., eds. Total hip prostheses.Bern: Hans Huber Verlag1976; 205–39.
36.
JohnstonR.C., BrandR.A., CrowninshieldR.D.. Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships.J Bone Joint Surg Am1979; 61: 639–52.
HartofilakidisG., KarachaliosT.. Total hip arthroplasty for congenital hip disease.J Bone Joint Surg Am2004; 86: 242–50.
39.
DearbornJ.T., HarrisW.H.. High placement of an acetabular component in total hip arthroplasty. Results after a mean of ten years.J Bone Joint Surg Am1999; 81: 469–80.
40.
MacKenzieJ.R., KelleyS.S., JohnstonR.C.. Total hip replacement for coxarthrosis secondary to congenital dysplasia and dislocation of the hip. Long-term results.J Bone Joint Surg Am1996; 78: 55–61.
