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Metal-on-metal dysplasia cup total hip arthroplasty for hip osteoarthritis secondary to developmental dysplasia of the hipGelişimsel kalça displazisine bağlı kalça osteoartriti için metal-metal displazi cup total kalça artroplastisi Developmental dysplasia of the hip (DDH) is the most common cause of secondary hip osteoarthritis. Dysplasia includes deformities such as hypoplastic acetabulum, narrow femoral intramedullary canal, leg-length discrepancy, shortened muscles around the hip, and abnormal neurovascular structures. All of these anatomical abnormalities require a challenging surgical operation in the treatment of dysplastic hips.In this study, we aimed to evaluate the clinical and radiological results of metal-on-metal dysplasia cup total hip arthroplasty (THA) for hip osteoarthritis secondary to DDH. İki hastada ameliyat sonrası siyatik sinir arazı gelişti. Bir hastada ameliyattan bir yıl sonra tekrarlayan çıkık meydana geldi. Ortalama cup inklinasyonu 46.5° idi (dağılım 42°-51°). Sekiz hastada heterotopik osifikasyon meydana geldi. Hiçbir hastanın asetabüler ve femoral komponenti anlamlı şekilde yer değiştirmedi veya çökmedi. Hiçbir implant revize edilmedi. Sonuç: Gelişimsel kalça displazisinde displazi cup TKA'nın erken dönem klinik ve radyolojik sonuçları tatmin edicidir.Anahtar sözcükler: Gelişimsel kalça displazisi; metal-metal kalça protezi; total kalça artroplastisi.Objectives: This study aims to evaluate the clinical and radiological results of metal-on-metal dysplasia cup total hip arthroplasty (THA) for hip osteoarthritis secondary to developmental dysplasia of the hip (DDH). Patients and methods: Between May 2009 and October 2011, THA was performed on 27 hips (7 Crowe type II, 9 Crowe type III, 11 Crowe type IV) of 22 patients (2 males, 20 females; mean age 43 years; range 25 to 63 years) with hip osteoarthritis secondary to DDH. All patients were evaluated clinically and radiographically. Results: Average follow-up period was 34.2 months (range 24-53 months). While mean Harris hip score (HHS) was 43 (range 30 to 72 points) preoperatively, it was 92 (range 87 to 98 points) at final follow-up. Two patients developed sciatic nerve palsy postoperatively. Recurrent dislocation occurred in one patient one year after the operation. Mean cup inclination was 45.6° (range 42°-51°). Heterotopic ossification developed in eight patients. No patient's acetabular and femoral component migrated or subsided significantly. None of the implants was revised. Conclusion: Early clinical and radiological results of metalon-metal dysplasia cup THA in DDH are satisfactory.Keywords: Developmental dysplasia of the hip; metal-on-metal hip prosthesis; total hip arthroplasty.

In this study, we aimed to evaluate the long-term clinical and radiological results of single-stage open reduction through a medial approach and Pemberton acetabuloplasty in developmental dysplasia of the hip. We treated 32 hips (22 patients) with developmental dysplasia by a single-stage open reduction through Ferguson’s medial approach and Pemberton acetabuloplasty. The procedure was performed bilaterally in 10 patients. The mean age of the patients at the time of the operation was 19.8 months (16–24 months). The mean follow-up period was 10.9 years (7–19 years). Group I avascular necrosis according to the Kalamchi and MacEwen classification was observed in two hips and group II in one hip. Radiologically, 90.6% of the hips were classified as Severin class I and 9.4% of the hips were classified as Severin class II. At the latest follow-up, 30 hips were assessed clinically as excellent and two hips as good. No patient required subsequent surgery. We conclude that single-stage medial open reduction and Pemberton acetabuloplasty represent an effective method for developmental dysplasia of the hip in children older than 15 months of age.