Total hip reconstruction in acetabular dysplasia.

In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found that the lateral acetabular rim plays an important role in the load transfer of the pelvic bone. When the superlateral rim was lacking, the load shifted to the posterosuperior rim and to the area of pubic support, and the stresses in all materials, especially in the cement and in the trabecular bone, increased greatly. At the cement-bone interface the tilting component of the shear stress increased threefold. In a model in which the dysplastic acetabulum was augmented by a rigidly fixed, load-transmitting bone graft, the stresses were considerably diminished.

[1]  Tronzo Rg,et al.  Anatomic restoration of congenital hip dysplasia in adulthood by total hip displacement. , 1975 .

[2]  C. Ranawat,et al.  Total hip replacement in congenital dislocation and dysplasia of the hip. , 1979, The Journal of bone and joint surgery. American volume.

[3]  R. Huiskes,et al.  Mechanical and textural properties of pelvic trabecular bone. , 1993, Journal of biomechanics.

[4]  P. Pynsent,et al.  The McKee-Farrar hip arthroplasty. A long-term study. , 1986, The Journal of bone and joint surgery. British volume.

[5]  W. Harris,et al.  Failure of acetabular autogenous grafts in total hip arthroplasty. Increasing incidence: a follow-up note. , 1990, The Journal of bone and joint surgery. American volume.

[6]  H. Mckellop,et al.  Cup containment and orientation in cemented total hip arthroplasties. , 1990, The Journal of bone and joint surgery. British volume.

[7]  A. Ohlin,et al.  Loosening of the Lubinus hip. 202 cases followed for 3-6 years. , 1990, Acta orthopaedica Scandinavica.

[8]  J. G. Andrews,et al.  A three-dimensional biomechanical model of hip musculature. , 1981, Journal of biomechanics.

[9]  K E Marks,et al.  A ten-year follow-up of one hundred consecutive Müller curved-stem total hip-replacement arthroplasties. , 1982, The Journal of bone and joint surgery. American volume.

[10]  J. Feagin,et al.  Low-friction arthroplasty in congenital subluxation of the hip. , 1973, Clinical orthopaedics and related research.

[11]  Hwj Rik Huiskes.  Biomechanics of artificial-joint fixation , 1991 .

[12]  W. Harris.  Bone grafting for acetabular deficiency in association with total hip replacement. , 1987, The Hip.

[13]  R. Crowninshield,et al.  A physiologically based criterion of muscle force prediction in locomotion. , 1981, Journal of biomechanics.

[14]  W. Hess,et al.  Total hip arthroplasty in chronically dislocated hips. Follow-up study on the protrusio socket technique. , 1978, The Journal of bone and joint surgery. American volume.

[15]  W. Harris,et al.  Femoral head autografting to augment acetabular deficiency in patients requiring total hip replacement. A minimum five-year and an average seven-year follow-up study. , 1986, The Journal of bone and joint surgery. American volume.

[16]  C. Dietschi,et al.  Mechanical function of subchondral bone as experimentally determined on the acetabulum of the human pelvis. , 1976, Journal of biomechanics.

[17]  F. Linde,et al.  Socket loosening in arthroplasty for congenital dislocation of the hip. , 1988, Acta orthopaedica Scandinavica.

[18]  G. Wolfgang,et al.  Femoral head autografting with total hip arthroplasty for lateral acetabular dysplasia. A 12-year experience. , 1990, Clinical orthopaedics and related research.

[19]  R. Johnston,et al.  Coxarthrosis after congenital dysplasia. Treatment by total hip arthroplasty without acetabular bone-grafting. , 1988, The Journal of bone and joint surgery. American volume.

[20]  W H Harris,et al.  Total hip replacement and femoral-head bone-grafting for severe acetabular deficiency in adults. , 1977, The Journal of bone and joint surgery. American volume.

[21]  K. Terayama,et al.  Radiology of low-friction arthroplasty of the hip. A comparison of socket fixation techniques. , 1990, The Journal of bone and joint surgery. British volume.

[22]  W H Harris,et al.  Complex total hip replacement for dysplastic or hypoplastic hips using miniature or microminiature components. , 1983, The Journal of bone and joint surgery. American volume.