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Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note

Introduction: For cases with extensive acetabular bone defects, we perform surgery combining the Kerboull-type (KT) plate and bone graft through direct anterior approach (DAA) in primary total hip arthroplasty (THA) requiring acetabular reconstruction as minimally invasive surgery. This paper provid...

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Autores principales: Matsumoto, Mikio, Baba, Tomonori, Ochi, Hironori, Ozaki, Yu, Watari, Taiji, Homma, Yasuhiro, Kaneko, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347370/
https://www.ncbi.nlm.nih.gov/pubmed/28287388
http://dx.doi.org/10.1051/sicotj/2017006
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author Matsumoto, Mikio
Baba, Tomonori
Ochi, Hironori
Ozaki, Yu
Watari, Taiji
Homma, Yasuhiro
Kaneko, Kazuo
author_facet Matsumoto, Mikio
Baba, Tomonori
Ochi, Hironori
Ozaki, Yu
Watari, Taiji
Homma, Yasuhiro
Kaneko, Kazuo
author_sort Matsumoto, Mikio
collection PubMed
description Introduction: For cases with extensive acetabular bone defects, we perform surgery combining the Kerboull-type (KT) plate and bone graft through direct anterior approach (DAA) in primary total hip arthroplasty (THA) requiring acetabular reconstruction as minimally invasive surgery. This paper provides the details of the surgical procedure. Methods: The basic structure of the Kerboull-type plate is a cruciform plate. Since the hook of the Kerboull-type plate has to be applied to the tear drop, a space for it was exposed. The tear drop is located in the anterior lower region in surgery through DAA in supine position. It was also confirmed by fluoroscopy as needed. The bone grafting was performed using an auto- or allogeneic femoral head for bone defects in the weight-bearing region of the hip joint. Results: Of 563 patients who underwent primary THA between 2012 and 2014, THA using the KT plate through DAA was performed in 21 patients (3.7%). The mean duration of postoperative follow-up was 31.8 months. The mean operative time was 188.4 min, and the mean blood loss was 770 g. The patients became able to walk independently after 2.4 days on average (1–4 days). On clinical evaluation, the modified Harris Hip Score was 45.6 ± 12.4 before surgery, and it was significantly improved to 85.3 ± 8.97 on the final follow-up. Discussion: DAA is a true intermuscular approach capable of conserving soft tissue. Since it is applied in a supine position, fluoroscopy can be readily used, and it was very useful to accurately place the plate.
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spelling pubmed-53473702017-03-22 Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note Matsumoto, Mikio Baba, Tomonori Ochi, Hironori Ozaki, Yu Watari, Taiji Homma, Yasuhiro Kaneko, Kazuo SICOT J Original Article Introduction: For cases with extensive acetabular bone defects, we perform surgery combining the Kerboull-type (KT) plate and bone graft through direct anterior approach (DAA) in primary total hip arthroplasty (THA) requiring acetabular reconstruction as minimally invasive surgery. This paper provides the details of the surgical procedure. Methods: The basic structure of the Kerboull-type plate is a cruciform plate. Since the hook of the Kerboull-type plate has to be applied to the tear drop, a space for it was exposed. The tear drop is located in the anterior lower region in surgery through DAA in supine position. It was also confirmed by fluoroscopy as needed. The bone grafting was performed using an auto- or allogeneic femoral head for bone defects in the weight-bearing region of the hip joint. Results: Of 563 patients who underwent primary THA between 2012 and 2014, THA using the KT plate through DAA was performed in 21 patients (3.7%). The mean duration of postoperative follow-up was 31.8 months. The mean operative time was 188.4 min, and the mean blood loss was 770 g. The patients became able to walk independently after 2.4 days on average (1–4 days). On clinical evaluation, the modified Harris Hip Score was 45.6 ± 12.4 before surgery, and it was significantly improved to 85.3 ± 8.97 on the final follow-up. Discussion: DAA is a true intermuscular approach capable of conserving soft tissue. Since it is applied in a supine position, fluoroscopy can be readily used, and it was very useful to accurately place the plate. EDP Sciences 2017-03-10 /pmc/articles/PMC5347370/ /pubmed/28287388 http://dx.doi.org/10.1051/sicotj/2017006 Text en © The Authors, published by EDP Sciences, 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Matsumoto, Mikio
Baba, Tomonori
Ochi, Hironori
Ozaki, Yu
Watari, Taiji
Homma, Yasuhiro
Kaneko, Kazuo
Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
title Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
title_full Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
title_fullStr Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
title_full_unstemmed Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
title_short Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
title_sort kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347370/
https://www.ncbi.nlm.nih.gov/pubmed/28287388
http://dx.doi.org/10.1051/sicotj/2017006
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