Total hip arthroplasty in dwarfism. A case report

Abstract

In dwarfism hip arthritis, usually secondary to hip dysplasia, is a common finding at an early age. In these patients a joint replacement is a demanding procedure due to the peculiar joint deformity and the small size of the bones. We present a case of a bilateral hip replacement in a dwarf patient. In order to reduce intraoperative complications and improve the joint kinematics a thorough preoperative planning was performed by a CT based computerised system. On the basis of the planning we chose a conical shaped stem that enable as to restore limb length and offset with a low risk of femoral fracture. In conclusion, we consider total hip replacement in dwarfism a safe and effective procedure if an accurate preoperative planning is performed.

Midterm Survivorship and Complications of Total Knee Arthroplasty in Patients With Dwarfism

“…There was no statistically significant difference in the overall rate of revision (odds ratio [6] Although there were no statistically significant differences in revision rates in our study, our results indicate a significantly higher need for knee manipulations after TKA due to stiffness in dwarfs. While it has been argued that standard prostheses along with diligent preoperative planning can result in equally positive functional outcomes, [16] our results may demonstrate the contrary radiographically. Since many dwarf patients in our cohort had components that demonstrated overhang, the increased propensity for stiffness may be associated with oversized components;…”

“…While dwarf patients were not predisposed to increased risk of malalignment compared with non-dwarfs, there was an association between dwarfism and longer operative times.Questions have been raised about whether short stature can be indicative of poorer prosthesis survivorship and increased rates of complications [5,6]. Although prior studies have demonstrated that there are many benefits of the procedure, including functional outcome improvement,[7,[14][15][16][17][18][19] they have not firmly established whether the results are comparable to those of normal stature. The use of a control group in our study allowed us to account for factors such as age, other relevant medical conditions (comorbidity index), and year of surgery for patients of normal stature.…”

Total Hip Arthroplasty in Patients with Skeletal Dysplasia

“…Surgical technique must be significantly modified to obtain good outcomes [13]. An unusually high incidence of periprosthetic femoral fractures and nerve injuries were noted in patients with dwarfism [1,4,17].…”

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

“…5,7 However, there is limited data on the efficacy of hip arthroplasty in patients that are several standard deviations shorter or taller than the norm in the Western population. [8][9][10][11][12][13] A few publications have reported acceptable short-term outcomes following THA in osteochondrodysplastic and shortstatured patients. [8][9][10][11][12] Chiavetta et al 13 reported on 62 THA performed in 37 patients with an average height of 142 cm at a mean 12.8 year-follow-up.…”

“…[8][9][10][11][12][13] A few publications have reported acceptable short-term outcomes following THA in osteochondrodysplastic and shortstatured patients. [8][9][10][11][12] Chiavetta et al 13 reported on 62 THA performed in 37 patients with an average height of 142 cm at a mean 12.8 year-follow-up. The authors found the patients having reliable pain and functional improvement (p < 0.001) with a high prevalence of complications, periprosthetic fractures, and mechanical failure.…”