Total Hip Arthroplasty For Treatment Of The Developmental Dysplasia Of The Hip

Objective To evaluate the effect of total hip arthroplasty (THA) in treating osteoarthritis(OA) secondary to the developmental dysplasia of the hip (DDH) .Methods We treated 98 hip joints of 85 patients with the osteoarthritis secondary to developmental dysplasia of the hip with total hip arthroplasty between January 2001 and January 2008 in the Department of Orthopaedics. 67 hip joints of 58 patients were followed up,31 hip joints of 27 patients were lost contact. There were 44 females and 14 males, the average age was 53.6(27-73years).According to the classification of Crowe, there were 22(27 hips) in type I , 18(21 hips) in type II, 7(8 hips) in type III, 11(11 hips) in typeIV. 2(2 hips) ever had an operation of acetabular osteotomy. All the cementless acetabular cups were placed at the original anatomic location,of those 43 hips were replaced with regular cementless acetabular cups (with the femoral head prosthesis ofΦ28mm) ;15 hips were reconstructed with smaller cups after deeper reaming the acetabulum(with the femoral head prosthesis ofΦ22mm); 9 hips placed the cup after autogenous femoral head structural grafting; 9 hips combined with subtrochanteric short. The ways of femoral prostheses fixation were as follows: cementless for 53 hips, cement for 14 hips. All patients were evaluated with the Modified Harris Hip Score. Radiographic evaluations were made preoperative and during follow-up.Results No infection or nerve injury occurred. The mean follow-up was 37 months (range 2-83 months). Modified Harris Hip Score improved from 55.3 to 90.0 points. There was no acetabular or femoral component revision because of mal-position orloosening of the prostheses in all patients. Radiographically, all the prostheses were in place, no loosening were detected. All bone grafts were integrated , fused with the host bone successfully;no evidence of collapse or absorption of the autograft was found in 9 hips treated with the autogenous femoral head structural grafting. Of the 9 hips treated with subtrochanteric short, 2 cases of peritrochanter fractures were detected, of which one was diagnosed intraoperatively and the other was diagnosed postoperatively. All 2 cases were revised by plates and wires fixation. Finally, 2 cases were healed. After a mean follow-up of 10 months, all the fracture line were unclear.Conclusions Total hip arthroplasty is an effective way in treating osteoarthritis secondary to the developmental dysplasia of the hip. Taking appropriate methods to reconstruct acetabulum with cementless acetabular cups at the original anatomic location according to the condition of the acetabulum is recommended.