[Release and balance of the soft tissue in total hip arthroplasty for patients with Crowe III and IV type developmental dysplasia of hip]

Lie-ming Lou, Zhen-jun Yao, Wei-ping Wu, Yong-xin Ran, Xing Wu, Shao-hua Li
Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery] 2007 August 15, 45 (16): 1095-7

OBJECTIVE: To summarize the surgical experience of release and balance of soft tissues around hip in total hip arthroplasty for patients with severe hip dysplasia.

METHODS: From January 2001 to January 2006, 29 patients (31 hips) of adult dysplasia of hip were included in the study. Among them, there were 22 females and 7 males, age from 38 to 65 years with average of 53 years. According to Crowe classification system, there were 22 in type III, 9 in type IV, and Harris score was 42.6 preoperatively. Total hip arthroplasty was performed via lateral approach. All the acetabular cups were reconstructed at the original anatomic location through release of soft tissue around hip to restore limb length, and techniques of balance of soft tissue were applied to extend force arm of hip abductor and improve its function.

RESULTS: All the patients had restoration of limb length (ranged from 2.5 cm to 4.5 cm). One case of postoperative dislocation was occurred due to slight large of acetabular obtuse angle. Follow-up for 1-5 years (average 3.2 years) in 29 patients, the Harris score increased to 85.4 postoperatively. All hips had released from pain and functioned well.

CONCLUSIONS: In order to restoration anatomic structure and physiologic function of affected hip, the technique of release and balance of soft tissues around hip should be applied and cautioned in arthroplasty of dysplastic hip.

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