Mid-term results of total hip arthroplasty for relapsed osteoarthritis after joint-preserving operations for coxarthriti
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ORIGINAL ARTICLE
Mid‑term results of total hip arthroplasty for relapsed osteoarthritis after joint‑preserving operations for coxarthritis compared to primary total hip arthroplasty Suguru Ohsawa1,2 · Syuji Koide2 · Takaaki Shibuya3 Received: 31 March 2020 / Accepted: 12 August 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purposes Several studies have reported no differences in outcomes between total hip arthroplasty (THA) of osteotomized hips and primary hip THA. However, our results were worse after THA for converted osteotomized hips. Therefore, this study’s aim was to clarify the differences between THA after osteotomy and primary THA for osteoarthritis in developmental dysplasia of the hip (DDH). Methods The data were collected retrospectively (December 1998–June 2013). The cohort contained patients with a previous osteotomy (40 femur osteotomies) for osteoarthritis with DDH who then underwent cementless THA (average 192 months after osteotomy). The clinical and radiographic outcomes of 40 hips (osteotomy group) were compared with a matched group of 40 hips after primary THA (primary group). THA was performed and investigated only in patients with DDH. Results The mean follow-up period of the osteotomy group was 133 months. One patient was lost to follow-up. They had significantly higher subluxation and a narrower canal than the primary group (p 2 mm [24]: in brief, (1) the change in the vertical distance between the inferior margin of the acetabular socket and the inferior margin of the ipsilateral tear drop; and (2) the change in the horizontal distance between the Köhler line and the center of the outer shell of the acetabular socket [24]. Ectopic bone formation was classified using the techniques of Brooker et al. [25]. Zones of the stems and sockets were classified according to techniques developed by Gruen et al. [26] and DeLee and Charnley [27]. Stem alignment was assessed as the angle between the longitudinal axes of the femoral intramedullary canal and the femoral component stem on AP radiographs [28]. An angle of 5° or more was considered varus or valgus stem implantation [28]. Bone mineral density (BMD) of the periprosthetic area was assessed from April 2010 by dualenergy X-ray absorptiometry (Hologic QDR 4500, Hologic Japan, Tokyo, Japan) [29]; 12 in the osteotomy group and 11 in the primary group were assessed. Bone mineral content (BMC, grams) and Area (cm2) of the Gruen zones 1–7 were each summed. Then, total BMC was divided by
Table 1 Baseline characteristics of the osteotomy and primary groups
total Area to determine the estimated average BMD around the stem [29]. Interobserver variation was evaluated by comparing measurements taken during the aforementioned assessments and classifications of 10 preoperative and postoperative radiographs by two of the authors (SO, SK) using the same radiographs.
Statistical analysis Characteristics of patients with and without osteotomy were compared using Student’s t tests and Fisher’s exact tests, as appropriate. The
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