[Total hip arthroplasty and problems encountered in patients with high-riding developmental dysplasia of the hip].

OBJECTIVES: We evaluated total hip arthroplasty in patients with high-riding developmental dysplasia of the hip with regard to surgical method and modifications, problems encountered during surgery, and follow-up results.

METHODS: A total of 42 hips (22 Crowe type III, 20 type IV) of 31 patients (29 women, 2 men; mean age 45.7 years; range 26-70 years) who underwent total hip arthroplasty were clinically and radiologically evaluated. In all cases, cementless acetabular components were placed in the true acetabulum. Fifteen acetabula required structural autografts. Cementless stems were used on the femoral side. Proximal metaphyseal step-cut osteotomy was performed in patients with high-riding hips of more than 4 cm. The mean follow-up period was 54.7 months (range 11 to 127 months).

RESULTS: The mean Harris hip score increased from 37.6 preoperatively to 91.02 at the end of follow-up. No acetabular autograft resorption or non-union were observed. Non-union and delayed union in the femoral osteotomy site were encountered in two patients, respectively. Two components (1 acetabular, 1 femoral) were revised during the follow-up period. Two sciatic and two femoral temporary nerve palsies occurred. One patient developed superficial infection and was treated by debridement and antibiotics. Brooker type I heterotopic ossification was observed in seven patients.

CONCLUSION: Total hip arthroplasty proved successful in high-riding developmental dysplasia of the hip.