Efficacy of total hip arthroplasty in the treatment of Crowe II and III developmental dysplasia of hip in adults

Abstract

Objective To investigate the short-term efficacy of total hip arthroplasty (THA) in the treatment of CroweⅡand Ⅲ developmental dysplasia of hip (DDH) in adults after displacing the hip center of rotation on inner and upper side. Methods Forty-eight DDH patients (58 hips) with THA treatment in Taizhou Central Hospital from April 2006 to July 2014 were enrolled and divided into the three groups based on Crowe types. The research groups including the CroweⅡgroup [n = 14 cases (19 hips)] and the Crowe Ⅲ group [n = 11 (14 hips)], were treated with the technique of displacing the hip center of rotation on inner and upper side during THA. The control group was the CroweⅠgroup [n = 23 (25 hips)], and was treated with the technique of anatomical reconstruction of acetabulum. The X-ray films on post-anterior position were rechecked on 3 days, 3 months, 6 months and 24 months after THA surgery. We evaluated the post-operation function with imaging examination and Harris score. Results The comparison of the mean vertical distance [(18.3 ± 2.5) mm, (25.4 ± 3.2) mm, (29.6 ± 4.8) mm] and horizontal distance [(27 ± 5) mm, (21 ± 4) mm, (21 ± 4) mm] between rotation center and inter-teardrop line in the CroweⅠ, Ⅱ and Ⅲ groups after surgery were significantly different (F = 10.992, 11.271; all P 0.05]. The mean Harris scores between CroweⅠgroups and CroweⅡ, Ⅲ groups before surgery were significantly different [(51 ± 15) vs. (43 ± 17), (51 ± 15) vs. (39 ± 16); all P 0.05). All patients had excellent gait without lamp and with negative Trendelanburg syndrome at the end of follow-up period. Conclusions The technology of acetabular reconstruction which displaces the hip center of rotation on inner and upper side can be an effective method in treating CroweⅡ and Ⅲ DDH. The short-term clinical efficacy and radiographic results achieved by this method are satisfied. Key words: Developmental dysplasia of the hip; Total hip arthroplasty; Crowe type