The Leg Length Balancing And Clinical Effect In Total Hip Arthroplasty For Unilateral Crowe Ⅳ Developmental Dysplasia Of The Hip Patients

ObjectiveIn order to detect the clinical effect of total hip arthroplasty(THA)for unilateral Crowe Ⅳ development dysplasia of the hip,we undertook a clinical follow-up study which includes 16 patients that received THA from May of 2014 to July of 2016 in the orthopedic department of Shandong Province Hospital.We collect and analyze the information about Harris score,Leg Length Discrepancy,low back pain,location of prosthesis that confirmed by X ray and regeneration of osteotomy.We hope the results can provide some advices for clinicians.Data and methodAll the data came from patients that received THR because of unilateral CroweⅣ development dysplasia of the hip during May of 2014 to July of 2016 in the orthopedic department of Shandong Province Hospital.Among the patients,male account 19%and female account 81%,the age range from 23 years to 46 years,and the average year is 40.94±8.68 years.The standard of diagnosis of Crowe Ⅳ type of hip dysplasia is:Type I:the displacement of femoral head is less than 50%of the height of femoral head,or less than 10%of pelvic height;Type Ⅱ:the displacement of femoral head accounts 50-75%of the height of femoral head,or the 10-15%of pelvic height;Type Ⅲ:the displacement of femoral head accounts 75-100%of the height of femoral head,or the 15-20%of pelvic height;Type Ⅳ:the displacement of femoral head exceeds 100%of the height of femoral head,or the 20%of pelvic height.In this follow-up study,all the patients suffered from unilateral Crowe IV type of hip dysplasia with high level of dislocation.And each had different levels of pains of hip joints and lower limbs,limps,dysfunction and lower limb malformation.The average Harris before THR is 35.63±7.53.the LLD is 3.2-4.3 cm,average 3.9 cm.Biomechanical,lateral or posterior approach of surgery and functional training were selected for each person.Then we collect data through clinic or telephone follow-up which contains Harris score,length differences of lower limbs,regeneration of osteotomy and location of prosthesis.Results16 patients were all followed and the average followed time is 13 months.According the results of the follow-up.pain was totally relieved in all patients.No infection,revision,nerve injury and DVT were performed in all patients.The postoperative Harris score is 90.50±3.93,the LLD is 1.02±0.37cm.The Harris score and LLD were evidently improved after THA.ConclusionsTHA is effective to reduce the pain of patients that suffered from unilateral Crowe IV development dysplasia of the hip,and it also has a prominent effect on recovering the gait and functional activity.Furthermore,lower limbs malformation is improved prominently and the range of hip joint activity is extended obviously.So,THR can be a good select for patients with high level dislocation of dysplasia hip when suffered from obvious pain and limitation of functional activity to improve the quality of life.