Arthroplasty in patients with congenital hip dysplasia – early evaluation of a treatment method. Marek Bożek , Tomasz Bielecki , Roman Nowak , Maciej Żelawski Ortop Traumatol Rehabil 2013; 15(1):49-59 ICID: 1032794
Article type: Original article
IC™ Value: 3.00
Abstract provided by Publisher
BACKGROUND: Developmental hip dysplasia (DHD) is the most common cause of secondary hip osteoarthritis (OA). It most often leads to OA in young, active and working adults.
The aim of our study was to evaluate the results of total hip arthroplasty (THA) in patients with DHD.
Material and Methods: Total hip arthroplasty was performed in 15 patients with DHD, including 13 women (average age 39 years) and 2 men (average age 44 years) between June 2010 and June 2011. The severity of degenerative arthritis in affected hips was assessed with Crowe’s classification. Patients were evaluated with the Harris Hip Score before and after the surgery.
Results: The mean preoperative Harris Hip Score was 44.6 points, compared to 62.4 immediately after surgery and 78.6 at six months post-surgery. After arthroplasty, improvement was noted in climbing stairs without railing, walking without support and sitting in a chair for more than 1 hour. Average limb length discrepancy before the surgery was 4 cm, decreasing to 0.5 cm after the surgery. Mean hip flexion was 40° at baseline and 90° after the surgery, and mean abduction was 0° and 25°, respectively. Our study thus demonstrates that total hip arthroplasty in patients with developmental dysplasia of hip helps to improve stability and mobility of the joint and reduce the pain.
Conclusions: 1. In Crowe’s Type 1 and 2 OA, good clinical results may be achieved using standard prosthesis stem sizes and press-fit acetabular components with possibly the smallest diameter providing for stable mounting. 2. In Type III OA, good results are observed with press-fit acetabular components implanted following reconstruction of bone defects with bone autografts. If a press-fit acetabulum cannot achieve primary stability, it should be fixed with screws. 3. The use of large headscan contribute to better osseointegration of the acetabular component and reduce the risk of dislocation.4. The short follow-up period of the study group requires a further prospective study of the same patients to evaluate long-term outcomes.