Applications of total hip prosthesis to patients with coxarthrosis that has developed due to developmental hip dysplasia

Abstract

The aim of this study was to evaluate the clinical and radiographic results of total hip arthroplasty (THA) for coxarthrosis secondary to developmental dysplasia of the hip (DDH). Examinations were made of 58 hips in 47 patients with DDH who were operated on between 1990-2000 (patients with anatomic centred hips with or without roof graft and/or femoral shortening). The patients were evaluated using the Modified Harris Hip Score pre- and postoperatively. The average Harris score increased from 47.7 preoperatively to 89.2 postoperatively. The average age of 43 female and 4 male patients was 48 years (24-65). All the patients presented with a limp, which was resolved after surgery in 34% and partially improved in others. The average medialization was 24 mm, and the average distal placement was 32 mm. A total of 28 (48%) complications were observed in 26 patients. Intraoperatively, fissures were detected in the proximal femur in 5, and were fixed with cerclage wiring. One patient with femoral shortening had hip dislocation one week later, so plate screw fixation was revised with open reduction. One patient had anterior thigh pain, heterotopic ossification was observed in three cases, and polyethylene wear in one case. All 20 patients who had superolateral acetabular grafting showed incorporation but there was observed to be resorption in a 20% section that was non-weight-bearing in 3 cases. THA is an effective treatment option for coxarthrosis in neglected DDH. Patients should be informed about the problems they may encounter after surgery and care should be taken in terms of complications such as dislocation, prosthesis infection, and vascular and nerve damage.

Keywords

• Developmental hip dysplasia
• coxarthrosis
• total hip arthroplasty
• Harris hip score

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