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. 2020;31(2):298-305.
doi: 10.5606/ehc.2020.74412. Epub 2020 Jun 18.

Long-term results of total hip arthroplasty in developmental dysplasia of hip patients

Nazmi Bülent Alp  1 , Gökhan Akdağ, Fahri Erdoğan
Affiliations

Long-term results of total hip arthroplasty in developmental dysplasia of hip patients

Nazmi Bülent Alp et al. Jt Dis Relat Surg. 2020.

Abstract

Objectives: This study aims to report the physiological and radiological long-term results of total hip arthroplasty (THA) combined with or without subtrochanteric osteotomy in a group of developmental dysplasia of hip (DDH) patients.

Patients and methods: This retrospective study included 90 hips of 59 patients (3 males, 56 females; mean age 45.7±10.9 years; range, 24 to 67 years) who underwent THA between January 1979 and March 2006. Thirteen patients needed subtrochanteric shortening. The evaluation was performed through Harris hip scores, physical examination, and radiological imaging.

Results: The follow-up period ranged from 5 to 32 years, and the mean follow-up period was 10.3±6.4 years. Revision was required in 17 hips out of 90. Twelve revisions were needed because of aseptic loosening of femoral or acetabular component, three were for fracture of the femoral stem, and two for protrusio acetabuli. Four patients had transient nerve palsy, and one had permanent nerve function loss. In one patient, nonunion was observed around the femoral osteotomy site. Harris hip score was remarkably improved compared to top preoperative values (48 vs. 88.2, p<0.01).

Conclusion: Although revision rates tend to increase in long-term follow-up, THA is one of the best treatment options in DDH patients to relieve pain, improve daily activity levels, and minimize the damage of the knee and lumbar region.

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Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1
Figure 1. Distribution of hips according to Crowe classification.[8]
Figure 2
Figure 2. Unilateral reconstruction of Crowe type IV hip. A 41-year-old female patient treated with cemented polyethylene acetabular component, cemented femoral component with subtrochanteric step-cut femoral shortening osteotomy augmented with cerclage wiring. Union was achieved at sixth postoperative month.
Figure 3
Figure 3. Bilateral hip dislocation of a 57-year-old female patient. Bilateral total hip arthroplasty was performed with cementless acetabulum with a cemented femoral component with polyethylene.
Figure 4
Figure 4. Kaplan-Meier survivorship curve of cases without revision.
Figure 5
Figure 5. Reconstruction with structural femoral head autograft with screws. Complete heterotopic ossification occurred around left hip.
See this image and copyright information in PMC

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