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General Orthopaedics

Total Hip Arthroplasty in Dysplastic Hips

International Society for Technology in Arthroplasty (ISTA)



Abstract

INTRODUCTION:

Management of developmental dysplasia of hip in adult is challenging and needs more to be understood in terms of ideal implant, position of acetabulum and operative technique. Patient may present very late, usually when osteoarthritic changes develop followed by pain. Operative management is difficult because of hypoplastic femoral medullary canal and shallow acetabulum filled with soft tissues. Altered anatomy of neurovascular structures also pose a risk of being injured during surgery.

AIMS:

The goal of this study was to evaluate late results of total hip arthroplasty in adults after a minimum of 5 years follow-up.

MATERIAL:

45 Total hip arthroplasties in 40 patients were performed for painful hip dysplasia between 2003 and 2012. These 45 procedures were performed in 40 patients mean aged 32 +/− 14 years [17–56]. 29 patients (32 hips) were males and 11 patients (13 hips) were females. Non cemented total hip arthroplasty was done in all cases with mean follow up of 6 years. Of the 45 hips, 6 were neglected, dislocated hips with proximal migration of femoral head. In such patients sub-trochanteric osteotomy was done to bring the femoral head up to the level of Acetabulum. 5 patients (5 hips) were lost to follow up; consequently, the functional results were evaluated for 40 hips (35 patients). Harris hip score was used to evaluate the functional and clinical results.

RESULTS and CONCLUSION:

Harris hip score improved in all patients. We concluded from this series that total hip replacement should be considered in all patients with painful dysplastic hip.

Key words: Developmental Dyplasia Hip, Total Hip Arthroplasty


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