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

Abstract

Developmental dysplasia of hip (DDH) is one of the well-known orthopedic pathologies that cause coxarthrosis. [1] Pelvic bandage, traction, open or closed reduction, femoral, and pelvic osteotomies are the treatment alternatives for DDH in the pediatric age group. [2,3] For end-stage osteoarthritis, total hip arthroplasty (THA) is the standard treatment. [4,5] In the literature, several studies have reported that the anatomical hip center reconstruction yields favorable biomechanical results among those patients. [6,7] Both acetabular and femoral abnormal anatomy make this re-establishment challenging for surgeons. Among those patients, complication rates are higher than the normal arthroplasty operations due to the pathological anatomy. In DDH patient population, changing abnormal anatomy to normal and to reduce complication rates and prolong prosthesis survival, specially designed implants are needed. In this study, we aimed to report the physiological and radiological long-term results of THA combined with or without subtrochanteric osteotomy in a group of DDH patients. PATIENTS AND METHODS A total of 90 hips of 59 patients (3 males, 56 females; mean age 45.7±10.9 years; range, 24 to 67 years) who 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.

Mid-term outcomes after total hip arthroplasty in 106 Crowe II/III hips: different hip center positions

“…The wear resistance of acetabular Liner was always a key factor that we must consider for young patients. Though the volumetric wear rates of polyethylene lining were very low 0.022 mm/year, proving highly crosslinked polyethylene was durable in THAs [17] and hip abnormal noise was mainly appeared in ceramic-onceramic THAs [18], the advantages of 4th-COC were also obvious in our experience [19]. However, most research on Crowe II/III had few such detailed surgical date [14].…”

Total Hip Arthroplasty With Subtrochanteric Osteotomy for Developmental Hip Dysplasia: A Long-term Follow-up Study

“…Alp et al. reported 5 nerve palsies in a cohort of 90 DDH THA cases [ 29 ]. In their cohort, 77 cases were performed without an SDO, and a transverse or step-cut osteotomy was performed in only 13 of these cases.…”

Anterolateral approach may be superior to posterolateral approach in controlling postoperative lower limb discrepancy in primary total hip arthroplasty: A single-center, retrospective cohort study

“…[ 1 - 3 ] Successful THA could provide adequate pain relief, restore hip function, improve quality of life, and obtain satisfied long-term outcomes. [ 4 ] Surgical approaches for THA have not changed much during recent decades. However, the efficacy of THA has been significantly improved with the good bone quality and good bone mineral density, eventually good bone strength which is crucial for the better survival of implants.…”