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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1149-1154.
doi: 10.1302/0301-620X.89B9.18908  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Circumferential osteotomy of the medial acetabular wall in total hip replacement for the late sequelae of childhood septic arthritis of the hip

Y.-Y. Lian, MD, PhD, Orthopaedic Surgeon, Associate Professor1; M.-C. Yoo, MD, PhD, Orthopaedic Surgeon, Professor2; F.-X. Pei, MD, PhD, Orthopaedic Surgeon, Professor1; Y.-J. Cho, MD, PhD, Orthopaedic Surgeon, Professor3; J.-Q. Cheng, MD, PhD, Professor4; and S.-W. Chun, MD, Orthopaedic Surgeon2

1 Department of Orthopaedic Surgery
2 Department of Orthopaedic Surgery, East-West Neo Medical Center, Kyung Hee University, Seoul 134-090, Korea.
3 Department of Orthopaedic Surgery, Kyung Hee Hospital, Kyunghee University, Seoul 130-702, Korea.
4 The Lab of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China.

Correspondence should be sent to Professor M.-C. Yoo; e-mail: myungchulyoo{at}126.com

We performed 52 total hip replacements in 52 patients using a cementless acetabular component combined with a circumferential osteotomy of the medial acetabular wall for the late sequelae of childhood septic arthritis of the hip. The mean age of the patients at operation was 44.5 years (22 to 66) and the mean follow-up was 7.8 years (5 to 11.8). The mean improvement in the Harris Hip Score was 29.6 points (19 to 51) at final follow-up. The mean cover of the acetabular component was 98.5% (87.8% to 100%). The medial acetabular wall was preserved with a mean thickness of 8.3 mm (1.7 to 17.4) and the mean length of abductor lever arm increased from 43.4 mm (19.1 to 62) to 54.2 mm (36.5 to 68.6). One acetabular component was revised for loosening and osteolysis 4.5 years postoperatively, and one had radiolucent lines in all acetabular zones at final review. Kaplan-Meier survival was 94.2% (95% confidence interval 85.8% to 100%) at 7.3 years, with revision or radiological loosening as an end-point when two hips were at risk.

A cementless acetabular component combined with circumferential medial acetabular wall osteotomy provides favourable results for acetabular reconstruction in patients who present with late sequelae of childhood septic hip arthritis.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General