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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
BONE AND JOINT DEFORMITIES - SCIENTIFIC PAPERS 100° CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPAEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Pavia, June 20-21, 2003
Minerva Ortopedica e Traumatologica 2003 April;54(2):119-22
Different prosthetic solutions in congenital hip dysplasia
Croce A., Brioschi D., Nella S. G., Borgo E.
I Divisione Istituto Ortopedico “G. Pini”, Milano, Clinica Ortopedica Università di Milano, I Scuola di Specializzazione Ortopedia e Traumatologia
Congenital hip dysplasia is an orthopaedic condition that presents the surgeon with problems in the choice of the type of prosthetic implantation to be employed. The anatomy of the coxofemoral joint is often altered by joint dysplasia or as a result of the sequelae of past operations.
We have carried out a retrospective study on the prostheses used from 1994 to 1999 in our Department in patients suffering from coxarthrosis due to dysplasia. Various parameters, including recovery of normal joint biomechanics, the normalisation of possible dysmetrias, the disappearance of the Trendelenburg phenomenon and the onset of peripheral neurological complications as well as the evaluation of the quality of periprosthetic bone stock by means of photonic double X-ray bone mineral density (DEXA) were considered in the evaluation of the various prosthetic implanations.
We found that in the course of recent years within our Department the use of cemented hip prosthesis implantation has gradually diminished to the advantage of non-cemented implantations.
Considering the comparatively young age of patients, (from 20 to 65), we recommend the use of non-cemented systems as their use makes it possible to maintain a valid range of motion but above all it makes it possible to preserve the bone stock in view of the fairly likely future revisiting of the prosthetic implantation.
In young patients with high functional demands it is therefore fundamental to use implantations that require minimal bone sacrifice, to choose a prosthesis that is able to guarantee good joint function (correct offset and corrections of dysmetrias) and finally to carefully choose the materials of the components to be utilised so as to lay the best foundations for a long life for the prosthetic implantation.