Intermediate-term results after uncemented total hip arthroplasty for the treatment of developmental dysplasia of the hip
- PMID: 20302556
Intermediate-term results after uncemented total hip arthroplasty for the treatment of developmental dysplasia of the hip
Abstract
Objectives: We aim to evaluate the restoration of the hip and limb length in patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH) using total hip arthroplasty (THA).
Patients and methods: Between February 1996 and September 2001, 65 hips in 55 patients (2 males, 53 females; mean age 48.6 years; range 37 to 60 years) with advanced osteoarthritis secondary to DDH underwent uncemented THA. According to the Hartofilakidis classification, 20, 27, and 18 hips were evaluated types I (dysplasia), II (subluxation), and III (dislocation), respectively. All of the acetabular cups were reconstructed in the original anatomic location. Structural autografts were used in seven hips to supplement the acetabular coverage. We evaluated all patients clinically and radiographically.
Results: All of the patients were followed up for 7-12 years. Preoperatively, the Harris score averaged 52.5, 48.41, and 45.28 in types I to III, respectively. At the final follow-up, the Harris score averaged 89.65, 87.44, and 83.28, respectively. The difference between the pre- and postoperative scores was significant (p=0.0001). Preoperatively, 26 patients (47.27%) had slight limps (length difference <1 cm), eight (14.55%) had moderate limps (length difference 1-3 cm), and 21 (38.18%) had severe limps (length difference >3 cm). At their final follow-up, four (7.27%) had severe limps. The limps of all of the patients improved significantly (McNemar's test p=0.0001). We observed aseptic loosening and subsidence in six hips. In seven hips, we used a femoral head autograft for the superior acetabular defect. We performed femoral shortening osteotomies only for two (3.07%) type III hips.
Conclusion: In addition to the standard procedure, structural bone autografting, medialization of the cup, and placing the acetabular component in the true acetabulum are important factors for successful intermediate-term results.
Similar articles
-
[Total hip arthroplasty with uncemented cup and femoral head autografts for coxarthrosis due to dysplasia].Zhonghua Wai Ke Za Zhi. 2004 Aug 22;42(16):1006-9. Zhonghua Wai Ke Za Zhi. 2004. PMID: 15363240 Chinese.
-
[Total hip arthroplasty for patients with osteoarthritis secondary to hip developmental dysplasia].Zhonghua Wai Ke Za Zhi. 2005 Feb 15;43(4):255-8. Zhonghua Wai Ke Za Zhi. 2005. PMID: 15842925 Chinese.
-
[Total hip arthroplasty for treatment of developmental dysplasia of the hip].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006 Jun;20(6):647-50. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006. PMID: 16827392 Chinese.
-
Acetabular considerations during total hip arthroplasty for hip dysplasia.Orthop Clin North Am. 2012 Jul;43(3):369-75. doi: 10.1016/j.ocl.2012.05.012. Orthop Clin North Am. 2012. PMID: 22819164 Review.
-
Challenges and solutions for total hip arthroplasty in treatment of patients with symptomatic sequelae of developmental dysplasia of the hip.Am J Orthop (Belle Mead NJ). 2011 Feb;40(2):87-91. Am J Orthop (Belle Mead NJ). 2011. PMID: 21720596 Review.
Cited by
-
Use of proximal humerus plates for the fixation of the subtrochanteric femoral shortening osteotomy during total hip arthroplasty for Crowe type IV developmental dysplasia of the hip patients.Jt Dis Relat Surg. 2020;31(2):306-311. doi: 10.5606/ehc.2020.73078. Epub 2020 Jun 18. Jt Dis Relat Surg. 2020. PMID: 32584730 Free PMC article.
-
Total hip arthroplasty (S-ROM stem) and subtrochanteric osteotomy for Crowe type IV developmental dysplasia of the hip.Indian J Orthop. 2016 Mar-Apr;50(2):195-200. doi: 10.4103/0019-5413.177575. Indian J Orthop. 2016. PMID: 27053810 Free PMC article.
-
Percutaneous Partial Tenotomy of ITB for Secondary Genu Valgum Developing After Total Hip Arthroplasty ın Patients wıth Crowe Type-Iv Dysplasia.Indian J Orthop. 2023 Feb 17;57(5):666-672. doi: 10.1007/s43465-023-00832-7. eCollection 2023 May. Indian J Orthop. 2023. PMID: 37128561 Free PMC article.
MeSH terms
Substances
LinkOut - more resources
Medical
Research Materials