The Related Research For Anatomy Variation Of Developmental Dislocation Of The Hip In Adult And The Prothesis Choice

Objective: To analysis the anatomic morphology parameter variation ofacetabulum and the femoral canal of the patient with developmental dislocation of thehip (DDH) secondary to osteoarthritis in adult, provide a theoretical basis for theclinical selection of the type of prosthesis and prosthesis model and get initial stabilityand good stress distribution; to explore the early efficacy of Zweymüller biologicalprosthesis treatment with developmental dislocation of the hip secondary toosteoarthritis in adult.Methods: According to the screening criteria, the cases of DDH secondary toosteoarthritis treated with Zweymüller prosthesis were collected. All43cases met theinclusion criteria, including31females and12males. All are Mongolian. Using theCrowe classification, Crowe20hips,19hips, III7hips, IV7hips. Collect thelower extremity total length of DR imaging data of the43cases treated with THA andHip3DCT data (image format was DICOM format). Measure the acetabulum and thefemoral canal by anatomic morphology, then compare the result with the controlgroup.43cases were performed operation using Zweymüller hip prosthesis. Clinic andradiograph evaluation were performed after the operation, and then scored by HarrisScore.Results According to Crowe classification, female: Crowe I93%, II55%, III84%, IV85%. The average ages is52.3±5.7yrs (23-70),The average weight is64.7±6.9kg(50-110),the average height is165.4±4.7cm (158-190). There was no statisticaldifferences in4groups with age,weight and height. The anatomical features of proximalfemur were similar among4groups of DDH. The canal flare indexes of DDH weresimilar. The height of femoral head center in DDH group were apparently lower than the control group. The neck-shaft angle in Crowe,II of DDH were apparently greaterthan Crowe III,IV of DDH. The anteversion angles of DDH group were greater.Therewere differences of the leg-length inequality, the neck-shaft angle and the canal flareindex between DDH group and the control group.43patients were followed up average60.2months. The Harris Score for last follow were88.9. The ratio of excellent and goodis89.7﹪.3cases with Sub-trochanter derotation and shortening osteotomy gain boneunion. thigh pain were Crowe I8,Crowe5,Crowe3,Crowe2.Conclusion There were variation anatomic forms of acetabulum and medullary cavityat the patients with DDH secondary to Osteoarthritis in adults, especially in Crowe III,IV. For the high dislocation of DDH in adults is treated with THA, anatomical variationmust be fully taken into account. The key for THA are the choose of prosthesis andpreparation of the small size prosthesis. Zweymüller cementless hip prosthesis have agood primary stability and a satisfactory outcomes.