Total hip arthroplasty for developmental hip dysplasia

Abstract

We reviewed 38 hip replacements in 33 female patients (mean age 55.3 years) with developmental hip dysplasia. One patient had died and the remaining 32 patients (36 hips) had a mean follow-up of 12.2 years (range 8 to 19 years). All hips were replaced using the Muller cemented implant and in 32 bulk femoral head autograft was used. In 33 hips the socket was reconstructed at the level of the true acetabulum. Complications included one intra-operative femoral fracture and two early dislocations. Correction of leg length discrepancy was possible in 30 patients. The post-operative mean modified Merle d' Aubigne and Postel scores for pain, movement and walking were 5.9, 5 and 5.3 respectively. One cup was revised due to aseptic loosening at ten years. All grafts united but minor graft resorption was noticed in 24 hips, moderate in two and major in one.Résumé Nous avons examiné 38 remplacements prothé-tiques de la hanche chez 33 femmes (âge moyen 55,3 ans) avec une dysplasie de la hanche. Une patiente était décédée et les 32 autres (36 hanches) avaient un suivi moyen de 12,2 ans ( 8 à 19). Toutes les hanches ont eu un implant type Muller cimenté et pour 32 une autogreffe massive de tête fémorale a été utilisé. Pour 33 hanches la cavité a été reconstruite au niveau du paléo-cotyle. Les complications comprenaient une fracture fémorale opératoire et deux luxations précoces. La correction de l'inégalité de longueur des membres inférieurs était obtenue chez 30 malades. Le score postopératoire modifié de Merle d'Aubigné et Postel pour la douleur, la mobilité et la marche étaient en moyenne de 5,9, 5 et 5,3 respectivement. Une cupule a été révisée pour un descellement aseptique à 10 ans. Toutes les greffes ont consolidé, mais une résorption mineure de la greffe a été remarquée dans 24 hanches, une résorption modéré dans deux hanches et majeure dans une.

Total hip replacement with an uncemented Wagner cone stem for patients with congenital hip dysplasia

“…Several treatments have been used for treating hip arthritis secondary to a dysplastic hip [8][9][10], but few studies consider the Wagner stem as a possibility. Professor H. Wagner designed this stem in 1990 for patients with proximal femur deformities.…”

The utility of digital templating in Total Hip Arthroplasty with Crowe type II and III dysplastic hips

“…Proper positioning of the hip centre prevents the acetabular component from loosening. Concerning loosening of the femoral stem, most reports have documented good survival rates in patients with dysplastic hips [13,16]. Because dysplastic hips have various degrees of hip dislocation, we osteotomised the femoral neck less than 1 cm proximal to the lesser trochanter in order to minimise the tension on the reconstructed hip.…”

Total hip replacement in developmental dysplasia using an oval-shaped cementless press-fit cup

“…But without additional support this is associated with high acetabular loosening rates [18]. Acetabular reconstruction by bulk femoral autografting or bone impaction grafting has been described in a variety of ways and represents probably the gold standard at the time [19][20][21][22]. Some surgeons have abandoned the use of bulk autografts especially in older patients, because of the increased operative time, need for more soft tissue exposure and concerns for graft resorption [23].…”