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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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.	王巖. 全髖關節置換治療髖關節發育不良應注意的問題. 中華外科雜志, 2009, 47(1):35-36.
3.	白志剛, 牛東生, 禹全恩, 等. 全髖關節置換術治療重度成人髖臼發育不良并骨性關節炎的療效分析. 中國骨與關節損傷雜志, 2011, 26(4):337-338.
4.	彭昊, 陳森, 鄭慧鋒, 等. 生物型假體全髖關節置換術治療成人髖關節發育不良繼發骨關節炎的療效評價. 中國矯形外科雜志, 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.	劉興炎, 高秋明, 樊曉海, 等. 高齡患者髖臼發育不良全髖置換術的圍手術期準備與療效分析. 中國矯形外科雜志, 2010, 18(9):705-708.
7.	王皓宇, 黃明, 高明杰, 等. 后外側入路高脫位髖關節假體重建軟組織處理. 解剖與臨床, 2011, 16(5):412-414.
8.	高偉強, 陳經勇, 成俊, 等. 自體股骨頭植骨生物型人工全髖關節置換治療髖關節發育不良的療效. 中國組織工程研究與臨床康復, 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.	吳顯培, 唐建東, 秦漢興, 等. 應用 S-ROM 全髖關節置換術治療Crowe Ⅳ型髖臼發育不良. 中華關節外科雜志(電子版), 2010, 4(3):338-343.
14.	Reiker?s 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, 郭雙紅, 龔躍昆, 等. 股骨轉子下疊加截骨的人工全髖關節置換術治療Crowe Ⅳ型成人發育性髖關節發育不良. 中國修復重建外科雜志, 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.	趙眾首, 孫俊英. 組配式 S-ROM 假體在髖關節發育不良及髖關節翻修術中的應用進展. 中國修復重建外科雜志, 2012, 26(9):1054-1057.
19.	楊飛, 武永剛. S-ROM 假體在Crowe Ⅲ、Ⅳ型成人髖關節發育不良中的應用體會. 中國骨與關節損傷雜志, 2010, 25(1):67-68.
20.	曹光磊, 沈惠良. 老年髖關節發育不良繼發骨關節炎患者行全髖關節置換術的臨床研究. 中華關節外科雜志(電子版), 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. 王巖. 全髖關節置換治療髖關節發育不良應注意的問題. 中華外科雜志, 2009, 47(1):35-36.
3. 白志剛, 牛東生, 禹全恩, 等. 全髖關節置換術治療重度成人髖臼發育不良并骨性關節炎的療效分析. 中國骨與關節損傷雜志, 2011, 26(4):337-338.
4. 彭昊, 陳森, 鄭慧鋒, 等. 生物型假體全髖關節置換術治療成人髖關節發育不良繼發骨關節炎的療效評價. 中國矯形外科雜志, 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. 劉興炎, 高秋明, 樊曉海, 等. 高齡患者髖臼發育不良全髖置換術的圍手術期準備與療效分析. 中國矯形外科雜志, 2010, 18(9):705-708.
7. 王皓宇, 黃明, 高明杰, 等. 后外側入路高脫位髖關節假體重建軟組織處理. 解剖與臨床, 2011, 16(5):412-414.
8. 高偉強, 陳經勇, 成俊, 等. 自體股骨頭植骨生物型人工全髖關節置換治療髖關節發育不良的療效. 中國組織工程研究與臨床康復, 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. 吳顯培, 唐建東, 秦漢興, 等. 應用 S-ROM 全髖關節置換術治療Crowe Ⅳ型髖臼發育不良. 中華關節外科雜志(電子版), 2010, 4(3):338-343.
14. Reiker?s 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, 郭雙紅, 龔躍昆, 等. 股骨轉子下疊加截骨的人工全髖關節置換術治療Crowe Ⅳ型成人發育性髖關節發育不良. 中國修復重建外科雜志, 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. 趙眾首, 孫俊英. 組配式 S-ROM 假體在髖關節發育不良及髖關節翻修術中的應用進展. 中國修復重建外科雜志, 2012, 26(9):1054-1057.
19. 楊飛, 武永剛. S-ROM 假體在Crowe Ⅲ、Ⅳ型成人髖關節發育不良中的應用體會. 中國骨與關節損傷雜志, 2010, 25(1):67-68.
20. 曹光磊, 沈惠良. 老年髖關節發育不良繼發骨關節炎患者行全髖關節置換術的臨床研究. 中華關節外科雜志(電子版), 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content