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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_6 | Pages 1 - 1
1 May 2019
Watkins C Ghosh K Bhatnagar S Rankin K Weir D Hashmi M Holland J
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Background

Total hip arthroplasty (THA) in patients with congenital dysplasia of the hip (CDH) is complex and challenging. The Crowe and Hartofilakidis classification systems are the most commonly used. However, neither encompasses the whole spectrum of disease and deformity and therefore does not guide modern surgical options.

We present a new classification system which aims to guide surgical strategy by focusing on the three main areas of disease and deformity: Cup defect; De-rotation of femoral neck ante-version; Height of femoral subluxation. Each component is graded from 1–3 based on the severity of deformity and the potential surgical strategy required (with 3 being the most severe). A total numerical score will reflect the overall degree of difficulty which may be used when assessing surgical outcomes.

The aim of this study is to assess the reliability of this new adult CDH classification system in the setting of THA.

Study design and Methods

A sample size calculation showed 28 evaluations were required to reach a power of 85% (based on a kappa value of 0.4). The anterior-posterior pelvis and lateral hip radiographs of 30 hips, in 26 patients were evaluated by three Consultant Orthopaedic Surgeons using the classification detailed in table 1. A second evaluation, with the case order randomised, was performed after a minimum period of 1month. Randolph's free multi-rater Kappa co-efficient was used to assess for inter and intra- observer reliability and 95% confidence intervals were calculated.


The Bone & Joint Journal
Vol. 98-B, Issue 3 | Pages 313 - 319
1 Mar 2016
Baker P Rankin K Naisby S Agni N Brewster N Holland J

Aims

The highly cross-linked polyethylene Exeter RimFit flanged cemented acetabular component was introduced in the United Kingdom in 2010. This study aimed to examine the rates of emergence of radiolucent lines observed when the Rimfit acetabular component was implanted at total hip arthroplasty (THA) using two different techniques: firstly, the ‘rimcutter’ technique in which the flange sits on a pre-prepared acetabular rim; and secondly, the ‘trimmed flange’ technique in which the flange is trimmed and the acetabular component is seated inside the rim of the acetabulum.

Patients and Methods

The radiographs of 150 THAs (75 ‘rimcutter’, 75 ‘trimmed flange’) involving this component were evaluated to assess for radiolucencies at the cement/bone interface by three observers.