[Total hip arthroplasty in patients with osteoarthritis secondary to developmental dysplasia of the hip: results after a mean of eight-year follow-up]

Abstract

Objectives: We evaluated eight-year results of total hip arthroplasty in patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH).

Methods: Total hip arthroplasty was performed in 31 hips of 29 patients (25 females, 4 males; mean age 54 years; range 35 to 78 years) with osteoarthritis secondary to DDH. According to the classification by Hartofilakidis et al., there were 13 type 1 hips, 13 type 2 hips, and five type 3 hips. The acetabular component was placed in the true acetabulum in all the hips. Hybrid and uncemented prostheses were used in six hips and 25 hips, respectively. Eight patients with severe acetabular deficiency required augmentation with an autogenous bone graft. Soft-tissue releases were performed in seven hips. Femoral shortening osteotomy was performed for high hip dislocations. All the patients were evaluated using the Merle d'Aubigne and Harris hip scores. The mean follow-up period was eight years (range 1 to 10 years).

Results: According to the postoperative Merle d'Aubigne and Harris hip scores, the results were excellent in eight hips (25.8%), good in 17 hips (54.8%), fair in five hips (16.1%), and poor in one hip (3.2%). The mean length discrepancy between the two extremities was 1.7 cm (range 0.5 to 2.5 cm). Complications included nonunion of the acetabular graft in one patient and superficial wound infection in two patients. Neurologic complications did not occur. Three patients required revision for loosening of the acetabular (n=2) or femoral (n=1) components.

Conclusion: Successful results can be obtained with good planning and proper surgical procedures in the treatment of osteoarthritis secondary to DDH.