Total hip arthroplasty in the treatment of neglected congenital dislocation or dysplasia of the hip

Abstract

Objectives: We evaluated our methods and short-term results of total hip arthroplasty in the treatment of neglected congenital dislocation or dysplasia of the hip. Methods: We performed total hip arthroplasty in 13 hips of 11 female patients (mean age 47.9 years; range 36-65 years) with osteoarthritis secondary to congenital dislocation or dysplasia. Patients with severe acetabular dysplasia required augmentation with bone grafts. In high-riding hips, femoral shortening osteotomy was performed. All patients were evaluated using the Merle d’Aubigne and Harris hip scores. Radiological evaluation was made using preoperative and follow-up anterioposterior and lateral radiographs. The average length of follow-up was 20.9 months. Results: According to Merle d’Aubigne hip scoring, average preoperative and postoperative functional scores were 4.33 and 5.66 for pain, 4.6 and 5.83 for range of motion, and 4.00 and 5.41 for walking ability, respectively. The Harris hip score increased from 60.75 to 91.6 at follow-up. Complications were noted in only two patients, being delayed union of femoral osteotomy and false-route of the stem, respectively. Conclusion: Total hip arthroplasty provides successful outcome in the treatment of neglected congenital dislocation of the hip. Improvement of technical modifications may further increase surgical success