gms | German Medical Science

Seventy-seven hips in 71 patients (male 3, female 69) with five years more follow-up were evaluated. For all patients we adapted Spongiosa Metal II Total hip System (ESKA Implants, Co. Ltd., Luebeck, Germany) combining with ceramic on ceramic articulation. The diagnosis before the surgery was dysplastic osteoarthritis for all patients, including seven hips in seven patients of the failed pelvic and / or femoral ostetomy, three hips in two patients of Perthes-like head deformity, two hips in two patients of the completely dislocated hip (unreduced congenital dislocation of the hip) and one hip after the hip desis. The average of the age at the surgery was 60. The average body weight was 54.2 kilograms. The average period of the follow-up was five years and seven months. As the additional procedure, we adapted the acetabuloplasty for eight hips, the acetabular medial wall displacement osteotomy for two hips, minor acetabular bone graft for 50 hips, and the adductor tendon release against the adduction contracture for nine hips. Before the surgery, the average amount of the hip score was 62. At the final follow-up, the average amount of the hip score was 89. In all patients, the score was improved (P<0.000, t=-18.29). During the surgery, eight cracks (10.8%) of the femur occurred. The femoral shaft crack occurred in seven hips and the trochanteric crack in one hip. Fortunately, all cracks had united without prolonging the after-treatment program. Some modification of the stem shape may be necessary for the deformed femur in the dysplastic hips. In one hip, a piece of the surface structure (Tripometal) dropped out during the surgery. The piece did not affect the course of the patient. There were no severe postoperative complications such as deep venous thrombosis, dislocation, infection, palsy, and breakage of the components. No patients required the revision surgery. The average inclination angle of the cup was 39.5 degrees. The average anteversion of the cup was 18.9 degrees. All cups were stable at the final follow-up. Seventy-six stems were stable. One stem slightly migrated into a varus position until two years after the surgery. However, after that the stem became stable until final of the follow-up. In the acetabulum, the radiolucent line was observed in two hips (2.4%). In both of two hips the line existed in zone I and VI. In the femur, the line was observed in 14 hips (14.3%). All lines existed in the proximal femur. There was no cystic osteolytic lesion on the radiographs. Ectopic bone formation occurred in nine hips (11.7%). Bone atrophy was observed in three hips (3.6%). Cortical hypertrophy was observed in three (3.6%) hips. These periprosthetic reactions had no clinical symptoms. For the dysplastic hips, the clinical results of Spongiosa Metal II with ceramic / ceramic articulation was satisfactory.