Application of 3D Printing Combined with S-ROM Total Hip Arthroplasty in the Treatment of Adult Crowe Ⅳ DDH / 昆明医科大学学报

Objective To investigate the application of 3D printing combined with S-ROM total hip arthroplasty in the treatment of adult Crowe IV DDH. Methods Between September 2014 and June 2017, 10 patients of adult Crowe IV DDH were selected and divided into 3D group (5 cases) and non-3D group (5 cases) . There were 4 males and 6 females with an average age of 43.6 years (range,27-63years) . Harris scores were recorded in both groups before the operation, and in the group 3D, patients underwent spiral CT scanning to make the hip 3D models. According to the hip 3D models, the sizes of prosthesis and operation schemeswere estimated before the operation ,and the surgery simulation was performed. Then the S-ROM prosthesis was used for total hip arthroplasty. The actual situation of hip joint, the size of prosthesis,time of operation and blood loss were recorded.Harris Score at 1 week post-operationwere recorded again. All patients were followed up related postoperative complications for at least 2 weeks.Results The 3D printing models coordinated with the actual sizes of the hips in the3D group.The time of operation and blood loss were less than the non-3D group. Higher Harris score was observed at 1 week post-operation in the 3D group,compared to non-3D printing group.The follow-up showed that the motion of the hips was improved obviously. Conclusion The Application of 3D Printing combined with S-ROM total hip arthroplasty in the treatment of adult crowe IV DDH can improve efficiency and accuracy of the operation, shorten time of operation , reduce operative blood loss and rate of complications.

Clinical results in early and mid term of using the S-ROM femoral stem in revision / 中国骨伤

<p><b>OBJECTIVE</b>To investigate and the clinical effect of S-ROM modular stem in femur reconstruction in hip revision arthroplasty.</p><p><b>METHODS</b>From January 2008 to January 2016, 21 patients received revision hip arthroplasties using S-ROM stems. There were 5 males and 16 females with an average of 48.33 years old(range, 29 to 73 years old). There were 13 cases caused by aseptic loosening, 4 cases by infection, 2 cases by nonunion of sub-tuberosity osteotomy, 1 case for repeated dislocation, 1 case for traumatic great trochanter fracture. Primary THA reasons:12 cases for DDH(9 cases for Crowe IV), 5 cases for femoral neck fracture, 2 cases for necrosis of femoral head, 2 cases for proximal femoral deformity caused by early infection. The femur bone defects included Paprosky II in 11 cases, IIIa in 9, and IIIb in 1. Harris hip score , pain score and hip flexion were recorded before and after operation. The subjective satisfaction was recorded at the last follow-up.</p><p><b>RESULTS</b>The operation time and blood loss were 189 min(125 to 290 min) and 867 ml (200 to 2 000 ml). At the final followup, the pain score improved from (17.14±9.56) points preoperatively to (41.71±2.03) points (=11.42,=0.00). The function score improved from (24.01±11.02) points preoperatively to (49.95±5.38) points (=9.73,=0.00). Harris hip score improved from (41.15±14.81) points preoperatively to(91.67±5.83) points(=15.33,=0.00). The degree of hip flexion increased from (93.10±27.27) points preoperatively to (121.90±16.62) points at the last follow-up (=4.59,=0.00). The mean subjective satisfaction was 9.48(10 points system), 14 of which were completely satisfactory. The last follow-up hip X-ray showed 21 cases of bone ingrowth, and other femoral stem without loosening or sinking sign significantly. There were 5 cases with bone anchor syndrome around proximal femoral cuff. There were 5 cases of proximal femur fracture, 3 cases of lesser trochanter fracture, 2 cases of greater trochanter fracture intra-operatively. Due to femoral canal stenosis, there were 4 cases of pre-tied wire at lesser trochanter to prevent fractures. There was 1 case of traumatic femoral fracture around stems with a distal oblique fracture, open reduction and locking plate fixation was performed. Other patients had no nerve stretch injury, dislocation, infection and lower limb deep vein thrombosis and other complications at the final follow-up.</p><p><b>CONCLUSIONS</b>S-ROM prosthesis has satisfactory results in hip revision arthroplasty with Paprosky II and III femoral defects. Especially for patients with Crowe IV DDH and other proximal femoral deformities, it is possible to adapt to the medullary cavity morphology. Excellent initial stability, less complications and long-term biological fixation can be achieved with S-ROM in femur revision.</p>

Total Hip Arthroplasty Using S-ROM Prosthesis for Dysplastic Hip

PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip. MATERIALS AND METHODS: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis. RESULTS: The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up. CONCLUSION: For advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria.

Revision Total Hip Arthroplasty with S-ROM Modular System

PURPOSE: To evaluate the clinical and radiological outcomes after revision total hip arthroplasty using the S-ROM modular system. MATERIALS AND METHODS: Twenty-three consecutive patients (24 hips) who underwent femoral stem revision with the S-ROM modular system were followed for more than two years. The average follow-up period was 44 months (range, 24~72 months), and the average age at the time of the revision was 48 years (range, 30~68 years). Underlying causes for revisions included 23 cases of aseptic loosening and 1 case of septic loosening. Femoral bone defects according to the Paprosky system were classified as type II in 12 hips, type III in 8, and type IV in 4. The clinical and radiographic results were evaluated. RESULTS: At the time of latest follow-up, there was no femoral stem loosening, osteolysis, radiolucency, or rerevision. Although 3 cases of Paprosky classification type IV showed subsidence, stable fibrous fixation was achieved in these hips. Complications included 1 intraoperative femoral shaft crack and 1 postoperative deep infection. CONCLUSION: We can achieve stable initial fixation using the S-ROM modular system with proximal press fitting sleeve and fluted stem.

Primary total hip arthroplasty using the modular S-ROM prosthesis for the treatment of severe developmental dysplasia of the hip / 中国矫形外科杂志

[Objective]To research short-term results of primary total hip arthroplasty using the cementless modular S-ROM prosthesis for the treatment of severe developmental dysplasia of the hip.[Method]Eighten patients(19 hips) with severe developmental dysplasia of the hip underwent primary total hip arthroplasty using the S-ROM prosthesis.Of the patients,6 were male and 12 were female.The average age was 32 years.According to the Crowe classification system,there were 11 hips in type Ⅲ and 8 hips in type Ⅳ.The acetabulums were deepened at the level of the true acetabulum.The S-ROM modular stems were used on the femoral side.Subtrochanteric shortening osteotomy was performed when it was difficult to reset.The Harris hip score(HHS) and radiography were used to evaluate the hip function preoperatively and at the follow-up.[Result]One proximal femur tissure fracture occurred,and was bundled up with circle wire.There were 2 postoperative sciatic nerve irritation,which disappeared completely within 3 months.All patients were available for follow-up.There was one heterotopic ossification above greater trochanter.But the mobility of the hip was normal.There was no loosening or infection during the follow-up.Average follow-up period was(2.8) years(range,6 months-5 years).The HHS increased from 38.4 preoperatively to 85.2 at the time of final follow-up.[Conclusion]S-ROM is a perfect choice for the teatment of severe developmental dysplasia of the hip.Short-time clinical results were excellent.