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Hip shelf arthroplasty indicated in dysplastic, spherical, non-OA hips
Patients with a dysplastic, spherical centered hip without osteoarthritis are the best candidates for hip shelf arthroplasty, according to this study.
Prior to surgery, researchers divided dysplastic hips into spherical and aspherical groups based on Tönnis grade osteoarthritic changes, according to the abstract. They analyzed the results of 25 hips in 18 patients for a mean 15-year follow-up following hip shelf arthroplasty.
In 19 spherical hips without osteoarthritic changes, hip shelf arthroplasty was successful at average 14-year follow-up, according to the abstract. Two patients developed hip osteoarthritis (OA) prior to hip shelf arthroplasty, but the effects of the procedure lasted more than 13 years and 20 years and surgeons performed total hip arthroplasty (THA) to treat OA as late as 15 years and 23 years, respectively.
Regarding aspherical hips, two patients had surgical effects until the 12-year and 15-year follow-up. One female patient from the spherical group developed hip OA at 10 years which was treated with THA, according to the abstract. Another female patient with an aspherical, decentered hip developed severe hip OA at 21 years that was also treated by THA.
“The best outcomes of Bosworth hip shelf arthroplasty may be expected in a dysplastic spherical centered hip without osteoarthritic changes,” the researchers stated in the abstract. “In the presence of asphericity, decentration and osteoarthritic changes, neither the effect of the surgery nor its survival can be clearly predicted.”