gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2017)

24.10. - 27.10.2017, Berlin

Results of the total hip replacement in patients with dysplasia who were operated in childhood

Meeting Abstract

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  • presenting/speaker Dmitrii Markov - Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation
  • Ksenya Zvereva - Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN33-973

doi: 10.3205/17dkou079, urn:nbn:de:0183-17dkou0791

Published: October 23, 2017

© 2017 Markov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objectives: We aimed to examine the results of total hip replacement (THR) in patients with dysplasia of hip joints who were operated in childhood.

Methods: We have analyzed the results of surgical treatment of 105 patients with dysplastic coxarthritis who were operated between 2013 and 2015. The inclusion criterions were pre-operation X-ray proved Crowe type I and 3-stage coxarthritis. The mean age of patients was 38±2.3 years (range 29 - 68). The female-male ratio consist of 94 (89,5%) women and 11 (10,5%) men. The mean shortening of the lower limb were 2±1.8 cm. All patients were divided into 2 groups. The 1st study group included 48 patients who were undergone surgical treatment in childhood about dysplasia of the hip. The 2nd study group included 57 patients who were undergone conservative treatment of dysplasia of the hip in childhood. The surgical approach - basically Moore's approach (74%), rarely Antero-lateral approach (26%). Surgery was performed under spinal anesthesia in 94% of cases, rarely under common anesthesia in combination with neuroleptanalgesia (6%). During operation the patients of the 1st group surgeon was observed an expressed scar process, deformation of the acetabulum, proximal femur and its medullary canal with a significant sclerosis, the definition and reconstruction of the center of rotation and the deficit of the soft tissue during closure of the surgical wound. It significantly complicates the technique of total hip replacement, increased time of the operation and intraoperative blood loss. In the postoperative period all patients received standard treatment. The follow-up period lasted 1 year and clinical and radiographs results after operative treatment were evaluated using Harris hip score system and antero-posterior and axial X-rays. STATISTICA Base (StatSoft Russia) was used for the statistical analyses by using Pearson's Chi-squared test, Student's t-test.

Results and Conclusion: Displacement of the prosthesis components, signs of aseptic instability in patients wasn,t marked on the X-ray during 1 year. Infectious complications weren't noted. The mean of the Harris hip score in the 1st group (84.9 points) statistically significantly differed from mean of the Harris hip score in the 2nd (89.8 points) group (p<0.01). In the 1st group 20 patients (41%) presented an excellent result, 28 patients (59%) - good result. In the 2nd group: 39 patients (69 %) - excellent result, 18 patients (31%) - good result.

Surgical treatment of the dysplasia in childhood decreases results of THR in adulthood.