Total hip arthroplasty for patients with Crowe type IV developmental dysplasia of the hip: Ten years results

Abstract

Background and objectives: The aim of this study was to determine the rate of union, functional results and complications in patients with Crowe IV developmental dysplasia of the hip (DDH) who underwent cementless total hip arthroplasty (THA) with S-ROM prostheses and subtrochanteric transverse shortening osteotomy.

Methods: Forty-five patients (52 hips) operated between January 2005 and May 2008, with a mean age of 40.6 years at surgery were followed. The mean follow-up period was 9.8 years. Clinical outcomes, radiographic outcomes and complications were evaluated.

Results: Osteotomy union occurred in 52 of 52 femurs (100%). Mean Harris hip score improved from 33.7 ± 4.7 preoperatively to 81.2 ± 6.3, 90.8 ± 5.3 and 89.8 ± 7.1 at 1, 5 and 10 years postoperatively. Two patients had temporary sciatic nerve paralysis postoperatively, and 2 patients experienced early postoperative dislocation. Two patients complained about mild longer limb length than the non-operated limb at the last follow-up. Three hips showed osteolysis in Gruen zone 1, and 1 hip showed osteolysis in zone 1 and 7. No implants were revised, and no signs of component loosening and migration were observed at the last follow-up visit.

Conclusions: S-ROM stem combined with transverse subtrochanteric shortening osteotomy in THA for patients with Crowe type IV DDH has good clinical results with small risk of complications.

Keywords: Developmental dysplasia of the hip; S-ROM stem; Subtrochanteric shortening osteotomy; Total hip arthroplasty.