Controlled Fracture of Medial Wall Versus Structural Autograft With Bulk Femoral Head to Increase Cup Coverage by Host Bone for Total Hip Arthroplasty in Osteoarthritis Secondary to Developmental Dysplasia of Hip: a Retrospective Cohort Study
Background: Many methods have been proposed to increase cup coverage by host bone during primary total hip arthroplasty (THA) in hip osteoarthritis secondary to developmental dysplasia of hip (DDH). However, there was no study comparing results of controlled fracture of medial wall with structural autograft with bulk femoral head. Methods: 67 hips classified as Crowe II/III were retrospectively included in this cohort study, which consisted of 33 controlled fracture (group A) and 34 structural
... and 34 structural autograft (group B). The Harris Hip Scores (HHS) was recorded. The radiological assessments were analyzed. Also, complications are assessed. The paired sample t test was used for data analysis before and after operation, while independent sample T test was used for the comparison between the two groups.Results: All patients were reconstructed acetabulum at anatomical location. HHS increased greatly for both groups (P=0.18). No statistic difference was observed for two groups in postoperative leg-length discrepancy ((0.51±0.29) cm for group A and (0.46±0.39) cm for group B, P=0.64 ), postoperative height of hip center ((2.25±0.42) cm for group A and (2.09±0.31) cm for group B, P=0.13), inclination of cup ((39±4)°for group A and (38±3)°for group B, P=0.65 ). The rate of cup coverage for group B ((94±2)% ) was better than group A ((91±5)%), ( P=.009). Rate of cup protrusio was (48±4)% for group A. For both two groups, no complications were observed at the latest follow-up. Conclusion: Controlled fracture of medial wall to increase cup coverage by host bone at anatomical location can act as an alternative technique for DDH Crowe II/III with advantage of shorter operation time and less technically demanding.