title: Cotyloplasty in cementless total hip arthroplasty for an insufficient acetabulum.
abstract: BACKGROUND
  Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of medial cup protrusion.
  
  
  METHODS
  Sixteen hips with insufficient acetabulum in sixteen patients were treated by cementless THA using cotyloplasty. The average patient age was 47 years. The diagnoses included dysplastic hip (12) and infection sequelae (4). All the patients were followed up for at least 2 years. Clinically, the Harris hip scores were assessed and radiologically, the amount of cup protrusion, the hip center movement and cup fixation were evaluated.
  
  
  RESULTS
  The average Harris hip score improved from 57 to 94 postoperatively. The average proportion of cup surface beyond the Kohler line was 44.1% and the hip centers were medialized by an average of 23 mm. Stable fixation of the acetabular cup was achieved in all the cases except one. In this one case, migration of the cup was detected 2 weeks postoperatively and a reoperation was performed.
  
  
  CONCLUSIONS
  Using cotyloplasty, good coverage of the acetabular cup was obtained without a block bone graft, and the hip joint centers were medialized. However, the safety margin for the amount of protrusion should be established.
authors.affiliation: Department of Orthopaedic Surgery, Inchon Medical Center, Inchon, Korea.
authors.forename: Yong Lae
authors.initials: YL
authors.lastname: Kim
authors.forename: Kwang Woo
authors.initials: KW
authors.lastname: Nam
authors.forename: Jeong Joon
authors.initials: JJ
authors.lastname: Yoo
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Hee Joong
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D001170:Arthritis, Infectious / Q000150:complications / Q000473:pathology; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006618:Hip Dislocation, Congenital / Q000473:pathology / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography
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