Acetabular cup position on high hip and anatomical position in total hip arthroplasty for Crowe III developmental dysplasia of hip joint

Abstract

To evaluate clinical outcomes of acetabular cup position on high hip and anatomical position in total hip arthroplasty for Crowe III developmental dysplasia of hip joint. Forty-six patients(58 hips) treated with high hip center THA from January 2010 to December 2015, including 6 males (8 hips) and 40 females(50 hips) aged from 40 to 70 years old with an average of(54.3±7.6) years old. While 20 patients(28 hips) treated with anatomical position in THA from January 2004 and December 2009 were analyzed as control, including 4 males (5 hips) and 16 females (23 hips), aged from 42 to 68 years old with an average of (53.0±7.1) years old. Operative time, blood loss, Harris score (HHS), gait analysis, Trendelanburg signal, imaging examinations and prosthesis survivorship were compared between two groups. Operative time and blood loss in high hip group(75.1±13.3) min and (108.4±47.1) ml respectively were lower than that of in anatomical position group(107.7±17.1) min and(201.0±58.6) ml respectively. There was no statistical difference in HSS score at 2 years after operation in high hip group(92.3±3.7) scores and anatomical position group(91.4±3.6) scores. No obvious meaning in lower limb differences in high hip group (3.8±2.1) mm and anatomical position group (3.5±1.6) mm. The vertical distance between center of rotation to teardrop in high hip group(31.6±7.8) mm was higher than that of anatomical group(19.3±7.4) mm;while there was no significant differences in horizontal distance between high hip group (30.1±7.7) mm and anatomical group(29.4±7.5) mm. There was no statistical significance in prosthesis survivorship. The gait was good without lameness and positive features of Trendelanburg signal caused by insufficient of abductor. For Crowe III DDH, a high hip center cementless cup without bone graft is a liable method with good function and high rate of prosthesis survivorship. And satisfying short-term clinical and radiographic results could be achieved by this method.