The Clinical Research Of Total Hip Arthroplasty For Congenital Hip Dysplasia In Adults

Purposes:To evaluated efficacy of total hip arthroplasty (THA) with different methods of proximal femoral osteotomy and acetabular reconstruction according to bone mass measurement in the treatment of congenital dysplasia of hip in adults.Methods:Between June 2004 to November 2010,54 cases of total hip arthroplasty in 51 patients,including 12 males and 39 females with a mean age of 47.9 years (25-68 years), with osteoarthritis secondary to congenital dislocation of the hip (CDH) were performed in our hospital. Preoperative diagnostic methods, including X-ray radiograph and CT examination and CT three-dimensional reconstruction. Were applied Crowe classification,22 cases 24 hips Crowen I; 14 cases 14 hips Crowe II, 4 cases of 5 hips Crowe III; 11 cases 11 hips Crowe IV. According to preoperative CT template evaluation, intraoperative acetabular reconstruction. Femoral side according to preoperative examination, Crowe III, Crowe IV dysplasia could through appling subtrochanteric osteotomy or proximal femur osteotomy with trochanteric slide technique. Follow-up, with Harris scoring system to assess hip function.Results:No infection,dislocation,traction injury of femoral nerve and ischiadic nerve were encountered in this series. Gait in patients with high dislocation were improved. 1 case of proximal femoral osteotomy delayed healing. Till the last follow-up,the average Harris hip score were improve from 36.1 points pre-revision to 92.5(74-99). Statistically significant difference was found according to t-test with P value less than 0.05.Conclusion:There are two difficulties in total hip arthroplasty for CDH, the first the pations with acetabular dysplasiawere adopted the application of CT templates, so that preoperative measurement of acetabular have a full assessment reasonable.Through the deeping acetabular or bulk structural bone grafting to obtain early stability and good bone tolerance. The second the pations with femoral dysplasia and the high dislocation were appled subtrochanteric osteotomy or proximal femur osteotomy with trochanteric slide technique, and its comparison of the two motheds.