[Reconstruction of hip center in total hip arthroplasty for developmental dysplasia of hip]

Xiongfeng Li, Guohua Guan, Jianyou Li
Chinese Journal of Reparative and Reconstructive Surgery 2012, 26 (9): 1037-40

OBJECTIVE: To explore the surgical technique and the effectiveness of reconstructing the hip center in total hip arthroplasty (THA) for developmental dysplasia of hip (DDH).

METHODS: Between January 2004 and January 2010, 29 patients (32 hips) with DDH underwent THA. There were 6 males (6 hips) and 23 females (26 hips), aged 45-67 years (mean, 50.6 years). The locations were left side in 22 hips and right side in 10 hips. According to Crowe classification, 12 hips were rated as Crowe I and 20 hips as Crowe II. The patients had limb length discrepancy of 1.9-4.4 cm. The Harris score was 50.7 +/- 8.6.

RESULTS: All incisions healed by first intension. Posterior hip dislocation occurred in 1 case (1 hip) after operation. All patients were followed up 2 years-4 years and 6 months (mean, 2.3 years). The lower limbs were lengthened by 0.5-5.8 cm (mean, 2.5 cm). The Harris score was 87.7 +/- 5.9 at 1 year after operation, showing significant difference when compared with preoperative score (t = 21.77, P = 0.00). X-ray films showed loosening of acetabular component in 1 case (1 hip) and displacement of acetabular component with too large abduction angle in 1 case (1 hip); no loosening and subsidence of acetabular or femoral components occurred in the other patients during follow-up. The horizontal location of hip center, the vertical distance between teardrop and the hip center, the vertical acetabular abduction angle, and the femoral offset were better than those before operation (P < 0.05).

CONCLUSION: For DDH patients, reconstructing the hip center in THA can lengthen the limb, improve the joint function, and reduce the failure rate of joint replacement.

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