Total Hip Arthroplasty For Developmental Dysplasia Of Hip In The Method Of Cutting Patrs Of The Trochanter

Total hip arthroplasty for developmental dysplasia of hip in the method of cuttingparts of the trochanterObjectiveThe basic pathologic defect in patients with developmental dysplasia of hip(DDH)，isa disturbance of enchondral ossification resulting in imperfect articular cartilage with lackof underlying osseous support that cannot withstand normal cyclical loading of the jointduring life.Although DDH is a disease occurring during childhood, it is seldomsymptomatic during the first2decades of life, and clinical problems related todegenerative arthritis manifest in early adulthood,especially in weight-bearing joints.Totalhip arthroplasty (THA) can be indicated in some adult patients with substantial pain anddisability from end-stage osteoarthritis of the hip joint. A relatively high rate ofcomplications related to component fixation continues to be a concern in these youngpatients with severe anatomical deformitiesPresent the clinical and radiographic results following THA in a consecutive series ofCrowe type Ⅳpatients with developmental dysplasia of hip (DDH), which were treated inthe method of cutting parts of the trochanter.Method32hips from30patients with developmental dysplasia of hip underwent total hiparthroplasty.Of the patients,3were male and27were female.The average age were35.9years(range17to67years).The mean follow-up period was55months(range24to132months).All patients taked preoperative routine examination,shot bilateral hip anteroposteriorfilm. We carried out a careful assessment of the situation of hip dysplasia,learnedhip true acetabular location,depth,size,anteversion, and the narrow canal of the proximalfemur.ResultsThree proximal femur tissure fractures occurred.And two were bundled up withresorption line,one was bundled up with circle wire.One low limb was swelling afteroperation,duing to the deep vein thrombosis.The swelling low limb recovered afterexpectant treatment.There was none neural injury.HHS score increased from37.6preoperatively to86.3postoperatively.All incisions were healing,no one was infected,and drainage pipe didn’t create bacteria. The average blood loss in patients was580ml (350~1400ml). Average operatingtime was110minutes (85-140minutes).Reviewed x-ray3months after surgery, fracture healed well. Femoral component waslocated in the femoral medullary cavity, prosthesis did not wear out the marrow. Allpatients could walk, out of the bed.After3months,patients could take normal dailyactivities.1year later,the x-ray showed significant bone length in the prosthesis. No casesof patients with prosthetic loosening. Lower limb length compared with preoperative,extended an average of3.2cm (2.5~4cm).ConclusionThe goals of THA in patients with skeletal dysplasia and advanced hip arthritis are torestore the biomechanical function of the affected hips by correcting femoral offset andgaining limb length to create a painless range of motion of the hip joints and to ensurestable component fixation with a minimum of complications. Adult patients with DDH andpremature end-stage osteoarthritis of the hip frequently present with severe anatomicaldeformities including a large, flat femoral head with poor acetabular coverage, a shortfemoral neck, coxa vara, and a high greater trochanter, and hence present considerabletechnical difficulties in performing THA.Treating the DDH in the method of cutting parts of the trochanter is convenience forthe doctor.The postoperative results were excellent,and it didn’t effect the muscle strengthof the affected limb.