Medium-Term Outcome of Total Hip Replacement for Dysplastic Hips in Singapore

Abstract

To review medium-term outcomes of 46 patients who underwent total hip replacement (THR) for osteoarthritis secondary to dysplastic hips. Records of 58 hips in 6 men and 40 women aged 32 to 76 (mean, 62) years who underwent THR for osteoarthritis secondary to dysplastic hips and had been followed up for a mean of 4 (range, 2-8) years were retrospectively reviewed. The hips were classified according to the Crowe's grading, Sharp's acetabular angle, and centre-edge angle. The radiological uncoverage of acetabular cup (RUAC) index was calculated. The outcomes of THR were evaluated in terms of cup inclination, RUAC index, cup migration, lysis or loosening (radiolucency), heterotopic ossification, component incorporation and positioning, thigh pain, and subsidence. 51 of the hips were Crowe's type I, 6 were type II, and one was type IV. The mean acetabular angle was 46.3 degrees and the mean centre-edge angle was 15.4 degrees. The mean cup, head, and stem sizes were 50.4 mm, 28.7 mm, and 10.9 mm, respectively. The mean RUAC index was 16.9% and the mean cup inclination was 40.7 degrees. Radiolucency of 1 mm in the acetabular zone I was observed in 16 cases, but only one failed. For cemented and uncemented stems, the most common positioning was neutral and valgus, respectively. Five patients had complications of greater trochanter fracture, aseptic loosening, split calcar, stem loosening, and/or heterotopic ossification. Conventional THR can achieve good medium-term results in low-grade dysplastic hips.