Cementless acetabular component with or without upward placement in dysplasia hip: Early results from a prospective, randomised study

Abstract

BackgroundTotal hip arthroplasty (THA) in developmental dysplasia of hip (DDH) is difficult for the abnormal acetabulum. The purpose of this study was to evaluate the difference of anatomic and upward placement of acetabular component during early stage. MethodsFrom April 2014 through June 2015, forty DDH patients (Crowe I to III, 42 hips) were prospectively randomized to either anatomic or upward group. Patient recorded diaries were collected. Radiographs were reviewed. WOMAC and Harris scores were tabulated from pre-operation to 12 months after surgery. ResultsThe patients' characteristics including age and body mass index (BMI) had no significant difference (P>0.05). There were no statistically differences between two groups for surgery time, intraoperative blood loss, hemoglobin (Hb), blood transfusion, albumin decrease, length of stay-day, but surgery time and blood loss in patients with structural bone graft was much higher in anatomic group. The postoperative limb-length discrepancy (LLD) was also no difference, but limb lengthening was better in anatomic group (P=0.042). The total hospital costs in the anatomic group were higher, but no significant differences. With regard to Harris and WOMAC score, there were significant improved after surgery in both groups, and the anatomic group was better in the value, but these differences were no statistically significant. ConclusionsAcetabular reconstruction for DDH subluxation should be reconstructed as close to the actual acetabular location as possible, but an appropriate (<20mm) upward placement that can achieve at least 70% native bone coverage of the acetabular implant is a valuable technique for early faster recovery.