Total Hip Arthroplasty For Developmental Dysplasia Hip

Background: End-stage osteoarthritis secondary to total congenital dislocation orsevere developmental dysplasia of the hip in adults presents a lot of special problems with regard to reconstruction of the hip. And it is generally agreed that the clinical and and radiographic results of total hip arthroplasty performed for degenerative arthritis secondary to developmental dysplasia of the hip vary depending on the severity of the anatomical abnormality.Objective: To evaluate the short-term and Mid-term clinical and radiographicresults of total hip arthroplasty performed for developmental dysplasia hips in our hospital.Methods: From 1995 to 2005, 123 total hip arthroplasty were performed in 104 patients who had osteoarthrosis secondary to acetabular dysplasia resulting from congenital dysplasia or dislocation of the hip. But only 41 hips in 34 patients got successful follow-up, 29 of whom were women and 5 men. The mean age at the time of the operation was 48.2 years (range 28 to 82 years), and the mean duration of follow-up was 3.9 years (range 4 months to 8 years). According to the classification of Crowe. 13 hips were grade I,17 were grade II, 4 were grade III. 7 were grade IV. The all acetabulars were reconstructed by porous-coated cementless cups, 21 hips also in conjunction with a femoral head autograft. Twenty-five femurs of them used cement femoral prostheses and 14 cementless. In 1 CroweIII hips and 5 Crowe IV hips were performed the proximal femoral shortening osteotomy using segmentalstep-cut technique. In all hips after shortening osteotomy, besides one AML prosthesis, high modular cementless S-ROM prostheses were used.Results: One of 41 acetabular components was failure for aseptic loosening, and nofemoral components were found failure. The mean Harris hip score for each of the four grade groups were 60 (grade I ), 52 (grade II), 45 (grade III). 40 (grade IV) preoperatively up to 92 (grade I ), 91 (grade II ), 88 (grade III), 82 (grade IV) postoperatively respectively. All autografts were seen to be united to host bone, no collapse of the graft bone. The proximal femur fracture was happened in One of 6 step-cut shortening osteotomy at about 2-week after operation and need revision. Others were all got successful bone union in osteotomy.Conclusions: These technique used in our hospital for hip reconstruction providedfavorable results and got reliable acetabular and femur fixation and appeared to restore acetabular bone stock in patients with developmental hip dysplasia.