EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY FOR SEVERE DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 ZHUJianxin , WANGYue , PANGJian , LÜBo , HUANGChongxin , HAOPeng , TANBo

Department of Orthopaedics, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu Sichuan, 610072, P. R. China;

Corresponding author：

ZHUJianxin, Email: 920930306@qq.com

Keywords：

Developmental dysplasia of the hip; Total hip arthroplasty; Adult

DOI：

10.7507/1002-1892.20140075

Video：

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Objective To evaluate the effectiveness of the total hip arthroplasty (THA) for severe development dysplasia of the hip (DDH) in adults. Methods Between July 2007 and January 2013, 25 patients (27 hips) with severe DDH underwent THA with cementless prosthesis. There were 10 males (11 hips) and 15 females (16 hips) with an average age of 38.6 years (range, 21-57 years). The left hip was involved in 10 cases, the right hip in 13 cases, and bilateral hips in 2 cases. There were 8 cases (9 hips) of Crowe type III and 17 cases (18 hips) of Crowe type IV. The main clinical manifestations were unilateral or bilateral hip pain, claudication, and limited motion of the hip. All patients had leg discrepancy with a length difference of (4.9±0.8) cm. Harris score was 32.7±2.9. Results All patients obtained primary healing of incision; no infection, dislocation, periprosthetic fracture, and lower extremity deep venous thrombosis occurred. All patients were followed up 1-5 years (mean, 3.7 years). Pain relief of the hip was obtained. The motion of the hip was improved obviously. At last follow-up, the length difference between lower limbs was (1.5±0.3) cm, showing significant difference (t=36.703,P=0.000) when compared with preoperative one. Normal gait was observed in the others except 3 cases having mild claudication. Harris score was 89.6±3.2, showing significant difference (t=-65.498,P=0.000) when compared with preoperative one. The X-ray films showed bone union of the acetabular structural bone graft and femoral osteotomy ends, and the union time was 3-5 months (mean, 4.6 months). No complication occurred as follows:dislocation, infection, prosthesis loosening or subsidence, and heterotopic ossification. Conclusion THA in the treatment of severe DDH in adults can obtain satisfactory short-term effectiveness, but long-term effectiveness needs further observation.

Citation： ZHUJianxin, WANGYue, PANGJian, LÜBo, HUANGChongxin, HAOPeng, TANBo. EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY FOR SEVERE DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(3): 335-338. doi: 10.7507/1002-1892.20140075 Copy

1.	Mahan ST, Katz JN, Kim YJ. To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg (Am), 2009, 91(7):1705-1719.
2.	王岩. 全髋关节置换治疗髋关节发育不良应注意的问题. 中华外科杂志, 2009, 47(1):35-36.
3.	白志刚, 牛东生, 禹全恩, 等. 全髋关节置换术治疗重度成人髋臼发育不良并骨性关节炎的疗效分析. 中国骨与关节损伤杂志, 2011, 26(4):337-338.
4.	彭昊, 陈森, 郑慧锋, 等. 生物型假体全髋关节置换术治疗成人髋关节发育不良继发骨关节炎的疗效评价. 中国矫形外科杂志, 2013, 21(15):1502-1507.
5.	Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1):15-23.
6.	刘兴炎, 高秋明, 樊晓海, 等. 高龄患者髋臼发育不良全髋置换术的围手术期准备与疗效分析. 中国矫形外科杂志, 2010, 18(9):705-708.
7.	王皓宇, 黄明, 高明杰, 等. 后外侧入路高脱位髋关节假体重建软组织处理. 解剖与临床, 2011, 16(5):412-414.
8.	高伟强, 陈经勇, 成俊, 等. 自体股骨头植骨生物型人工全髋关节置换治疗髋关节发育不良的疗效. 中国组织工程研究与临床康复, 2011, 15(26):4785-4787.
9.	Saito S, Ishii T, Mori S, et al. Long-term results of bulk femoral head autograft in cementless THA for developmental hip dysplasia. Orthopedics, 2011, 34(2):88.
10.	Boyle MJ, Frampton CM, Crawford HA. Early results of total hip arthroplasty in patients with developmental dysplasia of the hip compared with patients with osteoarthritis. J Arthroplasty, 2012, 27(3):386-390.
11.	Rejholec M. Combined pelvic osteotomy for the bipartite acetabulum in late developmental dysplasia of the hip:a ten-year prospective study. J Bone Joint Surg (Br), 2011, 93(2):257-261.
12.	Tokunaga K, Aslam N, Zdero R, et al. Effect of prior Salter or Chiari osteotomy on THA with developmental hip dysplasia. Clin Orthop Relat Res, 2011, 469(1):237-243.
13.	吴显培, 唐建东, 秦汉兴, 等. 应用 S-ROM 全髋关节置换术治疗Crowe Ⅳ型髋臼发育不良. 中华关节外科杂志(电子版), 2010, 4(3):338-343.
14.	Reikerås O, Haaland JE, Lereim P. Femoral shortening in total hip arthroplasty for high developmental dysplasia of the hip. Clin Orthop Relat Res, 2010, 468(7):1949-1955.
15.	Takao M, Ohzono K, Nishii T, et al. Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia. J Bone Joint Surg (Am), 2011, 93(6):548-555.
16.	李彪, 郭双红, 龚跃昆, 等. 股骨转子下叠加截骨的人工全髋关节置换术治疗Crowe Ⅳ型成人发育性髋关节发育不良. 中国修复重建外科杂志, 2013, 27(6):645-648.
17.	Park YS, Lim SJ. Long-term comparison of porous and hydroxyapatite sleeves in femoral revision using the S-ROM modular stem. Hip Int, 2010, 20(2):179-186.
18.	赵众首, 孙俊英. 组配式 S-ROM 假体在髋关节发育不良及髋关节翻修术中的应用进展. 中国修复重建外科杂志, 2012, 26(9):1054-1057.
19.	杨飞, 武永刚. S-ROM 假体在Crowe Ⅲ、Ⅳ型成人髋关节发育不良中的应用体会. 中国骨与关节损伤杂志, 2010, 25(1):67-68.
20.	曹光磊, 沈惠良. 老年髋关节发育不良继发骨关节炎患者行全髋关节置换术的临床研究. 中华关节外科杂志(电子版), 2010, 4(4):445-450.

1. Mahan ST, Katz JN, Kim YJ. To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg (Am), 2009, 91(7):1705-1719.
2. 王岩. 全髋关节置换治疗髋关节发育不良应注意的问题. 中华外科杂志, 2009, 47(1):35-36.
3. 白志刚, 牛东生, 禹全恩, 等. 全髋关节置换术治疗重度成人髋臼发育不良并骨性关节炎的疗效分析. 中国骨与关节损伤杂志, 2011, 26(4):337-338.
4. 彭昊, 陈森, 郑慧锋, 等. 生物型假体全髋关节置换术治疗成人髋关节发育不良继发骨关节炎的疗效评价. 中国矫形外科杂志, 2013, 21(15):1502-1507.
5. Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1):15-23.
6. 刘兴炎, 高秋明, 樊晓海, 等. 高龄患者髋臼发育不良全髋置换术的围手术期准备与疗效分析. 中国矫形外科杂志, 2010, 18(9):705-708.
7. 王皓宇, 黄明, 高明杰, 等. 后外侧入路高脱位髋关节假体重建软组织处理. 解剖与临床, 2011, 16(5):412-414.
8. 高伟强, 陈经勇, 成俊, 等. 自体股骨头植骨生物型人工全髋关节置换治疗髋关节发育不良的疗效. 中国组织工程研究与临床康复, 2011, 15(26):4785-4787.
9. Saito S, Ishii T, Mori S, et al. Long-term results of bulk femoral head autograft in cementless THA for developmental hip dysplasia. Orthopedics, 2011, 34(2):88.
10. Boyle MJ, Frampton CM, Crawford HA. Early results of total hip arthroplasty in patients with developmental dysplasia of the hip compared with patients with osteoarthritis. J Arthroplasty, 2012, 27(3):386-390.
11. Rejholec M. Combined pelvic osteotomy for the bipartite acetabulum in late developmental dysplasia of the hip:a ten-year prospective study. J Bone Joint Surg (Br), 2011, 93(2):257-261.
12. Tokunaga K, Aslam N, Zdero R, et al. Effect of prior Salter or Chiari osteotomy on THA with developmental hip dysplasia. Clin Orthop Relat Res, 2011, 469(1):237-243.
13. 吴显培, 唐建东, 秦汉兴, 等. 应用 S-ROM 全髋关节置换术治疗Crowe Ⅳ型髋臼发育不良. 中华关节外科杂志(电子版), 2010, 4(3):338-343.
14. Reikerås O, Haaland JE, Lereim P. Femoral shortening in total hip arthroplasty for high developmental dysplasia of the hip. Clin Orthop Relat Res, 2010, 468(7):1949-1955.
15. Takao M, Ohzono K, Nishii T, et al. Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia. J Bone Joint Surg (Am), 2011, 93(6):548-555.
16. 李彪, 郭双红, 龚跃昆, 等. 股骨转子下叠加截骨的人工全髋关节置换术治疗Crowe Ⅳ型成人发育性髋关节发育不良. 中国修复重建外科杂志, 2013, 27(6):645-648.
17. Park YS, Lim SJ. Long-term comparison of porous and hydroxyapatite sleeves in femoral revision using the S-ROM modular stem. Hip Int, 2010, 20(2):179-186.
18. 赵众首, 孙俊英. 组配式 S-ROM 假体在髋关节发育不良及髋关节翻修术中的应用进展. 中国修复重建外科杂志, 2012, 26(9):1054-1057.
19. 杨飞, 武永刚. S-ROM 假体在Crowe Ⅲ、Ⅳ型成人髋关节发育不良中的应用体会. 中国骨与关节损伤杂志, 2010, 25(1):67-68.
20. 曹光磊, 沈惠良. 老年髋关节发育不良继发骨关节炎患者行全髋关节置换术的临床研究. 中华关节外科杂志(电子版), 2010, 4(4):445-450.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY FOR SEVERE DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS

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