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Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 5, pp 729–734 | Cite as

Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty

  • Yusuke OsawaEmail author
  • Taisuke Seki
  • Yasuhiko Takegami
  • Taiki Kusano
  • Naoki Ishiguro
  • Yukiharu Hasegawa
Hip Arthroplasty
  • 32 Downloads

Abstract

Background

Acetabular wall defects after periacetabular osteotomy (PAO) lead to technical difficulties when performing subsequent total hip arthroplasty (THA). There is no unified consensus regarding the solution for THA socket installation after PAO. In the current study, we performed computed tomography (CT)-based simulation of socket installation and evaluated the acetabular defect following THA after PAO and after primary osteoarthritis (OA).

Patients and methods

The study group comprised 55 patients (56 hips) who underwent THA after PAO. For the control group, after matching for age, sex, and Crowe classification, we included 55 patients (56 hips) who underwent primary THA for hip dysplasia. We evaluated the anterior, posterior, and superior acetabular sector angle (ASA) and medial wall thickness (MWT) at the anatomical hip center (at the 20-mm vertical hip level from teardrop) in the study group (anatomical PAO group) and control group (primary OA group). In addition, we investigated the changes in the socket covering when the socket was positioned 10 mm above the anatomical hip center (30 mm above the teardrop; elevated osteotomy group).

Results

All ASA and MWT values were significantly smaller in the anatomical PAO group than in the primary OA group. In particular, the individuals with a Crowe classification of II/III in the anatomical PAO group presented severe acetabular defects. However, the elevated PAO group had a significantly larger ASA compared to the anatomical PAO group, with improved socket coverings.

Conclusion

Acetabular defects in the anatomical hip center following THA after PAO were significantly common compared to those after primary THA. Elevation of hip joint centers as much as 10 mm is one therapeutic option in the case of severe acetabular defects following THA after PAO.

Keywords

Acetabular wall defect Periacetabular osteotomy Rotational acetabular osteotomy Eccentric rotational acetabular osteotomy Total hip arthroplasty 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

All the authors state that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yusuke Osawa
    • 1
    Email author
  • Taisuke Seki
    • 1
  • Yasuhiko Takegami
    • 1
  • Taiki Kusano
    • 1
  • Naoki Ishiguro
    • 1
  • Yukiharu Hasegawa
    • 2
  1. 1.Department of Orthopaedic SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of RehabilitationKansai University of Welfare ScienceKashiwaraJapan

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