title: Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Myung Chul
authors.initials: MC
authors.lastname: Yoo
authors.forename: Yoon Je
authors.initials: YJ
authors.lastname: Cho
authors.forename: Kang Il
authors.initials: KI
authors.lastname: Kim
authors.forename: Kee Hyung
authors.initials: KH
authors.lastname: Rhyu
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Chun
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Chun
authors.forename: Hoon
authors.initials: H
authors.lastname: Oh
authors.forename: Eun Yeol
authors.initials: EY
authors.lastname: Kim
mesh_terms: 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