Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip.
BACKGROUND
We performed a retrospective study to evaluate the results of acetabular circumferential medial wall osteotomy, a procedure designed to provide secure fixation of a cementless hemispherical acetabular cup for the sequelae of septic arthritis of the hip.


METHODS
We assessed 38 total hip arthroplasties (THAs) with circumferential acetabular medial wall osteotomies performed on patients with sequelae of septic arthritis of the hip between 1993 and 2000, who were followed up for > or = 3 years. The average follow-up period was 8.3 years (range, 3 to 12 years). The indication for this technique was poor acetabular cup coverage of < or = 70% on preoperative templating. In all cases, cementless hemispherical acetabular cups were fixed to the true acetabulum. Additional procedures included soft tissue release in 16 hips and femoral derotational and shortening osteotomies in 12 hips. We evaluated both clinical and radiological results.


RESULTS
The Harris hip scores improved from 57 points preoperatively to 91 points postoperatively. Radiological analysis revealed no aseptic loosening or radiolucent lines around the acetabular cup. Stable bony fixation of the acetabular cup in the true acetabulum was seen in all cases. Acetabular osteolysis was demonstrated in 12 hips. Revision surgery was performed in 6 hips, but there were no complications related to acetabular circumferential medial wall osteotomy.


CONCLUSIONS
Circumferential acetabular medial wall osteotomy can provide appropriate positioning and sufficient coverage of the acetabular cup and thus preserve the medial wall thickness in cementless THA without the need for additional bone grafting for the sequelae of septic arthritis of the hip.
Yoo
Myung Chul
MC
Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
Cho
Yoon Je
YJ
Kim
Kang Il
KI
Rhyu
Kee Hyung
KH
Chun
Young Soo
YS
Chun
Sung Wook
SW
Oh
Hoon
H
Kim
Eun Yeol
EY
D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D001170:Arthritis, Infectious / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult