The outcome of periacetabular osteotomy in dysplastic hips is dependent on the absence of pre-operative osteoarthritis [OA]. The purpose of this study was to analyze whether Tonnis grading is a reliable predictor of OA in patients with hip dysplasia. Thirty patients were identified who had undergone hip arthroscopy surgery to assess their suitability for periacetabular osteotomy. Radiographs were assessed for anterior centre edge angle, lateral centre edge angle, Tonnis angle and Tonnis grade for OA changes. The radiographic grading of OA was compared with arthroscopic findings.Introduction
Methods
Reconstruction of an acetabulum following severe bone loss can be challenging. The aim of this study was to determine the outcome of acetabular reconstruction performed using trabecular metal shell for severe bone loss. Between June 2003 and June 2006 a total of 29 patients with significant acetabular bone stock deficiency underwent revisions using trabacular metal shell. According to Paprosky classification, there were 18 patients with grade IIIA and 11 patients with grade IIIB defects. Nineteen patients required augments to supplement the defects. Functional clinical outcomes were measured by WOMAC and Oxford hip. Detailed radiological assessments were also made. At most recent follow up (average 5.5 years, range 3.5–8.5) the mean Oxford hip score improved from 12 preoperatively to 27.11 postoperatively and WOMAC score from 17.57 preoperatively to 34.14 postoperatively The osseointegration was 83% according to Moore's classification. There were two reoperations; one was for instability, and one for aseptic loosening. One patient has a chronic infection and one had a periprosthetic fracture, both treated conservatively. Despite challenges faced with severe preoperative acetabular defects the early results using this technique in Grade III A and B is encouraging.
