Abstract:

BACKGROUND: Total hip arthroplasty is considered as an effective method for the treatment of hip dysplasia with advanced hip disease, but there exists many difficulties and risks.
OBJECTIVE: To evaluate the short-term outcome of cementless total hip arthroplasy for the treatment of Crowe- Ⅳ developmental dysplasia of the hip.
METHODS: Eighteen adult patients (22 hips) with Crowe-Ⅳdevelopmental dysplasia of the hip underwent primary total hip arthroplasty. All cases were accomplished through posterolateral approach bone cement fixation, and the greater trochanter osteotomy was performed to adjust the gluteal muscle tension. The acetabular cups were established at the level of the true acetabulum as near as possible.
RESULTS AND CONCLUSION: All the patients were followed-up for more than 10 months, and the longest follow-up time was 38 months. The mean lower limb length was 4.5 cm (3.4-6.0 cm) before surgery, and it was 4.0 cm longer than that before surgery (range 3.2-4.8 cm). The mean Harris hip score at the final follow-up after surgery was 87 (range 79-91) and was significantly increased than that before surgery (P < 0.01). During the replacement, 3 cases (3 hips) suffered from fracture with femoral prosthesis stability. And these three cases were treated with wire fixation or without any special treatment, and the X-ray film at 2 months after treatment showed that the fractures were healed. One case had the symptoms of sciatic nerve palsy after replacement and 3 months later, the symptoms disappeared. There was no loosening, dislocation, infection or deep venous thrombosis in any patient. Cementless total hip arthroplasty with osteotomy of the greater trochanter for Crowe -Ⅳ developmental dysplasia of the hip was an effective procedure to establish the biomechanics and improve the function of the hip.