| ObjectiveTo investigate the applicaionandeffect of the biological type acetabular cup(diameter≤44 mm) in adult Crowe type Ⅳ developmental dysplasia of the hip(DDH) with total hip of arthroplasty.Methods From April 2001 to August2013, biological type acetabular cup was used in total hip arthroplasty for the treatment of Crowe type Ⅳ of DDH in 16 cases(20 hips).There were 3 males and 13 females, aged 31-69 years, average of 49 years. Unilateral hip was involved in 12 cases, and bilateral hips in 4 cases. Congenital dysplasia was rated as Crowe type Ⅳ in all patients. The patients showed pain of the hip joint and inequality of lower limb. Acetabular deformity werecomfirmed on the X-ray films. The preoperative Harris score was(34.0±6.9).ResultsAll patients achieved healing ofincision by first intention, with no complications of infection or nerve and blood vessel injury. Sixteen cases were followedup for 4-9 years(mean, 7.5 years). At 2 weeks after operation, dislocation occurred in 2 cases,and was fixed with plasterfor 3 weeks after reduction of the hip. The X-ray showed that the average superolateral bone coverage in these 20 hips was more than 98.5 percent.The cup was an average of(4.6~7.0) mm(mean, 5.8mm). medial and(4.5~7.9) mm(mean,6.2mm). superior to the Ranawat triangle.Located inside the iliopectineal line and Kohler line of the acetabular cup lateral surface area was <40%.Cup abduction angle was(45±5)degrees, anteversion angle was(10 ± 5) degrees.The other patients had no prosthesis looseningexcept1 patient having extensive acetabularprosthesis loosening becauseof acetabular osteolysis at 12 years after operation. The hip Harris score was significantlyimproved to(85±7.5) at 1 year after surgery.Conclusion The acetabular grinding process to retainenough bone combined with asmall cup of biological prosthesis has the advantages of satisfactory coverage and initial acetabular fixation, so good early and mid-term curative effects was expecting. |
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