Article
Total hip arthroplasty in Crowe type III and IV Developmental Dysplasia of the Hip
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Authors
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Afshin Taheriazam
- Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran, Islamic Republic of
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Farshad Safdari
- Bone, Joint and related tissues research center, Shahid Beheshti University of medical sciences, Tehran, Iran, Islamic Republic of
| Published: | October 23, 2017 |
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Outline
Text
Objectives: Total hip arthroplasty (THA) for deficient acetabulum in patients with (DDH) is technically demanding and challenging. In current study, we prospectively investigated the short-term outcomes of THA in patients with Crowe type III or IV DDH.
Methods: Between 2009 and 2014, we operated on 90 dysplastic hips in 87 patients. Three patients underwent bilateral THA. There were 72 females and 18 males aged 46.3±5.2 years at the time of surgery. For Crowe type IV, proximal femoral shortening using digastric trochanteric osteotomy was performed followed by trochanteric wiring. In two of these patients, supracondylar shortening osteotomy was performed due to the severely deformed knee joint. Shelf graft was used due to the uncovered cup in 3 patients. Patients were followed for 2.3±1.2 years.
Results and Conclusion: At the final visit, Harris hip score averaged 86.4±7.1. Limb length discrepancy (LLD) decreased significantly from 6.6±2.5 cm to 1.1±1 cm (p<0.001). Peroneal nerve palsy developed in one patient resolved after 4 months. Dislocation occurred in one patient due to falling from stairs. Loosening or radiolucency and infection was not seen in our patients. THA in dysplastic hips sufficiently is associated with pain relief and improved functional status. In addition, proximal femoral shortening with digastric osteotomy is helpful in patients with Crowe type IV DDH to decrease the LLD. However, long-term results are necessary to investigate the survival of the prostheses.
