Total hip arthroplasty with acetabular reconstruction and without femoral shortening osteotomy for developmental dysplasia of the hip with complicated deformity.

Abstract

Objective To observe the clinical results of total hip arthroplasty (THA) with acetabular reconstruction and without femoral shortening osteotomy for developmental dysplasia of the hip (DDH) with complicated deformity. Methods Between December 2004 and December 2008, 20 patients (21 hips) with Crowe type Ⅲ, Ⅳ DDH combined with osteoarthritis were treated. The mean age was 32.1 years (19-44 years) and limb shortening 4.6 cm (3.0-6.5 cm), and preoperative Harris score was 44.3±16.7. All cases were accomplished through posterolateral approach and underwent acetabular reconstruction with autograft of femoral bead and periarticular soft tissue releases without sabtroehanteric shortening osteotomy. The limb-length discrepancy, complications and rehibilitation process were observed, and radiographic examination and Harris hip score were recorded. Results All patients were followed up for 8-48 months. The lengthen-ing of the operated limb was 2.9-5.3 cm after THA. The postoperation radiography showed good position of the prosthetic components. All patients had no static contraction abnormality at operated limb. Two patients with numbness in lateral leg after the procedure recovered completely in 1 month. No other complication was observed except heterotopic ossification in 2 patients. At the final follow-up examination, Harris hip score significantly increased to 86.3±10.7. Conclusion THA with aeetabular reconstruction and without shorten-ing femoral osteotomy for DDH with complicated deformity is effective procedure to improve hip function and biomeehanical reconstruction, which ean avoid disadvantage of femoral shortening osteotomy. But post-operative early rehibilitation must be individuation and completed gradually, to avoid nervous and vascular comphcation. Key words: Arthroplasty; replacement; hip; Hip dislocation; congenital; Osteoarthritis; hip