Results Of Total Hip Arthroplasty For The Osteoarthritis Secondary To Developmental Dysplasia Of The Hip

Objective The aim of this study was to evaluate the early clinic outcome of short-stem total hip arthroplasty for osteoarthritis secondary to the Crowe type I and II developmental dysplasia of the hip (DDH) cases.Methods Between October2007and August2012, twelve consecutive patients (eighteen hips) with the diagnosis of osteoarthritis secondary to Crowe type I and II DDH underwent short-stem total hip arthroplasty. Their average age at the time of surgery was38.7years (range,29-46years). Four patients (33.3%) were male and eight (66.7%) were female. Clinical and radiographic results were recorded before and after operation. The times of follow-up were performed at6weeks,3,6,9months and then once a year.Results All patients were followed for a mean time of24months (6-48months). During the follow-up period, no such complications as dislocation, fracture or infection occurred. As to the clinical outcomes, according to the Harris hip score, improved significantly from44±6.28score preoperatively to91±5.26postoperatively. In addition to the pain completely relieved, the range of hip motion was remarkably improved and no restriction was needed3months after operation.The radiographic analysis in the follow-up showed that all prostheses were fixed with no radiolucencies. For the patients who were unilateral DDH with preoperative limb-length discrepancy (LLD) from0.8to1.7cm, all regained almost equal limb length postoperatively, the LLD was under0.5cm.Conclusions The short-stem total hip arthroplasty may be a reasonable option for osteoarthritis secondary to the Crowe types Ⅰ and Ⅱ DDH, who were young and active. Objective To retrospectively analyze the methods and clinical outcome of treatment on Crowe type IV DDH (developmental dysplasia of the hip)in young adults with THA (total hip arthroplasty) and limb-lengthing external fixator.Methods From Oct2007to Jan2012, twelve patients(2male and10female) with unilateral Crowe type IV DDH were adimtted into our department. The mean age was25.7years old (18-35years old). We adopted two-staged surgical method, in the first stage, the patients underwent soft tissue relaxation and iliofemoral distraction with use of an external fixator for10-17days. There were1-2cm distraction at the first time and3-5mm daily distraction. When the femoral bead was distracted to the level of anatomical position, the second stage—THA was used. In the second stage, all patients underwent uncemented prosthesis with bulk femoral head autograft for acetabular reconstruction. The acetabular cup was placed in the anatomical position in every patient. Shortening femoral osteotomies were not required.Results The average follow-up was13.6months, no patient had a pin-site infection, hip joint infection, prosthesis loosening or nerve injury. Limb-length discrepancy was5.6cm on average preoperatively and0.5cm on average postoperatively. The Harris hip score was increased from45.7±2.59preoperatively to92.3±3.26postoperatively, the difference was statistically significant.Conclusion For the Crowe type Ⅳ DDH in young adults, we could restore nearly normal limb length and avoid nerve injury via continuously limb-lengthing by external fixator before THA. Therefore, we were able to safely place the acetabular cup at the anatomical position without femoral shortening.