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

ObjectiveTo evaluate the effect and operation key point of THA in treating secondary to the DDH.Methodswe treated 40 hip joints of 32 patients with the secondary to DDH with THA from January 2007 to january 2009 in the department of orthopadics.32hip joints of 26 patients were followed up. Three were 8 males and 18 females, the average age was 55.9 Y, the youngest 47 Y the oldest 65Y. According to the classification of Crowe, there were 10 hip in typeⅠ,8 hip in typeⅡ,10 hip in typeⅢ,4 hip in typeⅣ. Nobody had an operation of acetabular osteotomy, all the cementless acetabular osteotomy. All the cementless acetabular cup were placed at the original anatomic location.All patients had advanced osteoarthritis performance.32 hip,14 cases had their bone structure set. Acetabular side are the use of biological-type prosthesis, the femur side of the main biological type, only 3 cases were replaced cement type. Acetabular prosthesis implanted in the oringal location.14 hips acetabular restructed by autogenous femora lhead structural graftin. The results use of modified Hariss score and X-ray imaging to assess.ResultsNo postoperative infection or serious complications such as nerve damage. Harris score improved from preoperative to postoperative average 51.4 average 90.4. No postoperative prosthesis position mal-position (Outreach angle 50.0±4.3, anteversion 20.3±4.4), no cases of prosthesis loosening. Imaging Display:metal acetabular cup no looseing were detected; femoral prosthesis without sinking, some patients can be seen in the bone bed prosthesis translucent lines, but all＜1mm.14 cases of restruced acetabular cup healing well without obvious absorption collapse. Afte operation reach 69% excellent and 31% good rate. Preoperative and postoperative Harris score improved with increasing levels of Crowe typing into a negative correlation. Total hip arthroplasty for hip dysplasia good effect to resolve the pain。the patient are mostly moderate or more pain before surgery, most patients can get a pain-free joints. After CroweⅢ3 patients (30%) and CroweⅣ2 patients (50%) had mild thigh pain degree. Analyze the reasons:two patients were thigh and knee pain preoperative.It is hip joint disease induced the knee joint pain-related; others were marrow cavity narrow related. After analysis of the thigh, knee acesodyne effect may not improve with hip acesodyne effect parallel; marrow narrow, and biological prosthesis fixation may also lead to another reason for postoperative thigh pain. The functional improvement of patients related preoperative limb length, Crowe classification degree whether the merger severe valgus knee deformity and/or clubfoot deformity related.ConclusionThe THA is the best option treatment of DDH expecially with advanced osteoarthritis. It relief and restore joint movement and joint stability aspect very well. If you want master this kind operation very difficulty,it was a long learning cycle. You must accumulate sufficient experience and knowledge and do well prepare in pre-operative design, conceived intraoperative risk and how to candled these dangerous. Otherwise, opteration may damaged patients health much.