[Total hip arthroplasty for treatment of developmental dysplasia of the hip]

Abstract

Objective: To summarize the techniques of the total hip arthroplasty in the treatment of osteoarthritis secondary to developmental dysplasia of the hip joint (DDH).

Methods: Between February 1986 and November 2004, a total of 32 hips in 24 patients with advanced osteoarthritis secondary to DDH underwent the total hip arthroplasty. Among the patients, 4 were male and 20 were female, with their ages ranging from 33 to 59 years and an average age of 47 years. The bilateral arthroplasty was performed in 8 patients and the unilateral arthroplasty in 16 patients. The patients mainly suffered from pain and claudication. According to the Hartofilakidis classification, semidislocation occurred in 2 hips, low-dislocation in 21 hips, and high-dislocation in 9 hips; and the Harris scores before operation were 56.70 +/- 2.75, 36.09 +/- 4.16, and 29.45 +/- 2.16, respectively.

Results: All the patients were followed up for 6 months to 8 years (averaged 3 years and 4 months). The Harris scores after operation were 93.10 +/- 2.10, 92.7 +/- 3.20, and 88.09+/- 3.67, respectively. The differences between preoperation and postoperation were significant (P < 0.01). All the patients were pain-free and there was no sign of aseptic loosening and subsidence.

Conclusion: The total hip arthroplasty is an effective method for the treatment of osteoarthritis secondary to DDH. The key techniques for the total hip arthroplasty are as follows: deepening the medial wall of the acetabulum, improving the techniques of the bone graft, and firmly placing the acetabular component in the true acetabulum.