Treatment Of Total Hip Replacement To Adult Developmental Dysplasia Of The Hip With Secondary Bone Inflammation (Analysis Of 24 Cases)

Objective: Use total hip replacement in the treatment of adult Developmental Dysplasia Of the Hip with secondary osteoarthritis and analyze the changes of imaging indexes.Methods: From January 2010 to January 2016,24 cases of adult developmental dysplasia of the hip with secondary osteoarthritis were treated with total hip replacement.Among them,there were 5 males and 19 females,and the maximum age is 74,the minimum age is 37,the average is 49.75.There were 9 cases of left hip,11 cases of right hip and 4 cases of double bilateral.Standard pelvic orthotopic films were routinely taken and the following indexes were measured in all patients before the operation:(1)the Center Edge Angle(CE angle): the angle between the central point of the femoral head and the lateral edge of the acetabulum;(2)Sharp angle:the angle between the connection of the lower edge of the teardrop and the lower edge of the tear drop to the upper acetabulum;(3)Acetabular Coverage(AHI): the femoral head is divided by the transverse diameter of the acetabular cover by the transverse diameter of the femoral head;(4)Acetabular Depth: the maximum distance between the superior margin of the pubic symphysis and the upper margin of the acetabulum to the bottom of the acetabulum;(5)Femur Eccentricity(FO): the vertical distance between the center of the hip rotation and the longitudinal axis of the femoral shaft.Femoral bone cement prosthesis was used in 2 cases,cementless prosthesis in 26 cases,acetabular bone cement prosthesis in 3 cases,cementless prosthesis in 25 cases,and 3 cases in prosthesis placed prosthesis,all cases weren’t been bone grafted.The standard pelvic radiographs were also taken one week after the operation and the CE angle,Sharp angle,AHI,acetabular depth and FO imaging index were all measured.Statistical analysis of all the above data was conducted to determine the effect of total hip replacement on adult developmental dysplasia of the hip with secondary osteoarthritis.Result: The results were compared and analyzed according to the imaging data before and after the operation,and the results were indicated by the average number of standard deviation:CE angle preoperative mean 13.7496±3.9292,postoperative mean45.8039±9.9329,t=18.1887,P<0.001.Sharp angle preoperative mean 48.0657±5.4796,postoperative mean 39.9800±6.2612,t=6.1561,P<0.001.Acetabular coverage(AHI)Preoperative 0.5280±0.1153,postoperative 0.8457±0.0791,t=10.5497,P<0.001.Acetabular depth preoperative 0.8564 ± 0.396,postoperative mean 1.1800 ±0.3951,t=4.1532,P<0.001.Preoperative mean of femur eccentricity(FO)2.8250 ± 0.7481,postoperative mean4.0179±0.7852,t=7.9737,P<0.001.CE angle,Sharp angle,acetabular coverage rate,acetabular depth and femoral eccentricity index were statistically different before and after operation.P<0.001 showed significant difference,indicating that all imaging indexes were significantly improved after operation.Conclusions: 1.Total hip replacement is an effective method for the treatment of adult developmental dysplasia of the hip with secondary osteoarthritis.2.For the patients of developmental dysplasia of the hip with secondary bone inflammation,the preoperative size and location of acetabular and femoral prosthesis can be assisted by preoperative imaging evaluation of the hip joint,and the imaging indicators can be evaluated by X-ray.These are the keys to achieve good surgical treatment effects.