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Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 5, pp 723–728 | Cite as

Outcomes in 385 developmental dysplastic hips requiring total hip arthroplasty

  • Lauren J. Seo
  • Jonathan Gabor
  • David Novikov
  • James E. Feng
  • Ran Schwarzkopf
  • Jonathan M. VigdorchikEmail author
Hip Arthroplasty
  • 43 Downloads

Abstract

Background

Patients with developmental dysplasia of the hip (DDH) require special surgical considerations for total hip arthroplasty (THA). Despite the difficulties posed by the population’s anatomical abnormalities, few large evaluations of postoperative outcomes exist. This study seeks to characterize outcomes following primary THA among patients diagnosed with DDH.

Methods

A retrospective review was conducted at a tertiary care center on all THA patients between June 2011 and March 2018. Inclusion criteria for this study included any patient diagnosed with DDH undergoing primary THA. Baseline information, operative reports, and postoperative outcomes were pulled from the medical record.

Results

In total, 336 patients (385 hips) undergoing a THA between June 2011 and March 2018 were included. The average age was 52.6 ± 13.0 years and body mass index was 27.8 ± 6.0 kg/m2. Most patients were female (82%). The majority of hips (89%, n = 344) were Crowe type 1, followed by 2 (6.9%, n = 26), 3 (2.6%, n = 10), and 4 (1.3%, n = 5). Most hips were Hartofilakidis Class A (83%, n = 320), followed by Class B (15%, n = 59), then C (1.6%, n = 6). Mean follow-up was 24.8 months. Revision THA was required in 19 (4.9%) cases, with the most common indications being infection (2.1%) and periprosthetic fracture (1.0%). Readmission rates were 1.8% (7 hips) and 2.9% (11 hips) at 30-day and 90-day, respectively. The 30-day and 90-day ED visit rates were 1.3% (5 hips) and 2.1% (8 hips), respectively. No complications were seen following 344 (87%) THAs.

Conclusion

Despite their surgical complexity, DDH patients on average have notably low rates of revision and dislocation. Longer follow-up is needed to better assess outcomes after THA in this complex patient population.

Keywords

Congenital Developmental Dysplasia Hip Arthroplasty Replacement 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 1.
    Kotlarsky P, Haber R, Bialik V, Eidelman M (2015) Developmental dysplasia of the hip: what has changed in the last 20 years? World J Orthop 6:886–901.  https://doi.org/10.5312/wjo.v6.i11.886 CrossRefGoogle Scholar
  2. 2.
    Kubo H, Pilge H, Nepp K, Westhoff B, Krauspe R (2018) Development of unstable hips after treatment with the Tubingen splint: mid-term follow-up of 83 hip joints. Arch Orthop Trauma Surg 138:629–634.  https://doi.org/10.1007/s00402-018-2882-4 CrossRefGoogle Scholar
  3. 3.
    Clohisy JC, Dobson MA, Robison JF, Warth LC, Zheng J, Liu SS, Yehyawi TM, Callaghan JJ (2011) Radiographic structural abnormalities associated with premature, natural hip-joint failure. J Bone Jt Surg 93:3–9.  https://doi.org/10.2106/JBJS.J.01734 CrossRefGoogle Scholar
  4. 4.
    Weinsten SL, Mubarak SJ, Wenger DR, Developmental hip dysplasia and dislocation: part I. J Bone Jt Surg. 85 (2003)Google Scholar
  5. 5.
    Karimi D, Kallemose T, Troelsen A, Klit J (2018) Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty. Arch Orthop Trauma Surg 138:581–589.  https://doi.org/10.1007/s00402-018-2900-6 CrossRefGoogle Scholar
  6. 6.
    Jacobsen JS, Bolvig L, Holmich P, Thorborg K, Jakobsen SS, Soballe K, Mechlenburg I (2018) Muscle-tendon-related abnormalities detected by ultrasonography are common in symptomatic hip dysplasia. Arch Orthop Trauma Surg 138:1059–1067.  https://doi.org/10.1007/s00402-018-2947-4 CrossRefGoogle Scholar
  7. 7.
    Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Jt Surg 61:15–23CrossRefGoogle Scholar
  8. 8.
    Hartofilakidis G, Stamos K, Ioannidis TT (1988) Low friction arthroplasty for old untreated congenital dislocation of the hip. J Bone Joint Surg Br 70:182–186CrossRefGoogle Scholar
  9. 9.
    Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N (1996) Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Jt Surg 78:683–692CrossRefGoogle Scholar
  10. 10.
    Greber EM, Pelt CE, Gililland JM, Anderson MB, Erickson JA, Peters CL (2017) Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip. J Arthroplasty 32:S38–S44.  https://doi.org/10.1016/j.arth.2017.02.024 CrossRefGoogle Scholar
  11. 11.
    Sanchez-Sotelo J, Berry DJ, Trousdale RT, Cabanela ME (2002) Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options. J Am Acad Orthop Surg 10:334–344.  https://doi.org/10.5435/00124635-200209000-00005 CrossRefGoogle Scholar
  12. 12.
    Wang D, Li L-L, Wang H-Y, Pei F-X, Zhou Z-K (2017) Long-term results of cementless total hip arthroplasty with subtrochanteric shortening osteotomy in crowe type IV developmental dysplasia. J Arthroplasty 32:1211–1219.  https://doi.org/10.1016/J.ARTH.2016.11.005 CrossRefGoogle Scholar
  13. 13.
    Zeng W-N, Liu J-L, Wang F-Y, Zhang X, Fan H-Q, Chen G-X, Guo L, Duan X-J, Zhou Q, Yang L (2017) Total hip arthroplasty for patients with Crowe type IV developmental dysplasia of the hip: Ten years results. Int J Surg 42:17–21.  https://doi.org/10.1016/J.IJSU.2017.04.029 CrossRefGoogle Scholar
  14. 14.
    Iorio R, Clair AJ, Inneh IA, Slover JD, Bosco JA, Zuckerman JD (2016) Early results of medicare’s bundled Payment initiative for a 90-day total joint arthroplasty episode of care. J Arthroplasty 31:343–350.  https://doi.org/10.1016/j.arth.2015.09.004 CrossRefGoogle Scholar
  15. 15.
    Bayliss LE, Culliford D, Monk AP, Glyn-Jones S, Prieto-Alhambra D, Judge A, Cooper C, Carr AJ, Arden NK, Beard DJ, Price AJ, The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study., Lancet (London, England). 389 (2017) 1424–1430.  https://doi.org/10.1016/S0140-6736(17)30059-4
  16. 16.
    Engesæter LB, Furnes O, Havelin LI (2008) Developmental dysplasia of the hip—good results of later total hip arthroplasty. J Arthroplasty 23:235–240.  https://doi.org/10.1016/J.ARTH.2007.03.023 CrossRefGoogle Scholar
  17. 17.
    Cameron HU, Botsford DJ, Park YS (1996) Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty 11:582–587CrossRefGoogle Scholar
  18. 18.
    MacKenzie JR, Kelley SS, Johnston RC (1996) Total hip replacement for coxarthrosis secondary to congenital dysplasia and dislocation of the hip. Long-term results. J Bone Joint Surg Am 78:55–61CrossRefGoogle Scholar
  19. 19.
    Numair J, Joshi aB, Murphy JC, Porter ML, Hardinge K (1997) Total hip arthroplasty for congenital dysplasia or dislocation of the hip. Survivorship analysis and long-term results. J Bone Jt Surg 79:1352–1360CrossRefGoogle Scholar
  20. 20.
    Sochart DH, Porter ML (1997) The long-term results of Charnley low-friction arthroplasty in young patients who have congenital dislocation, degenerative osteoarthrosis, or rheumatoid arthritis. J Bone Jt Surg 79:1599–1617CrossRefGoogle Scholar
  21. 21.
    Yang S, Cui Q (2012) Total hip arthroplasty in developmental dysplasia of the hip: Review of anatomy, techniques and outcomes. World J Orthop 3:42–48.  https://doi.org/10.5312/wjo.v3.i5.42 CrossRefGoogle Scholar
  22. 22.
    Yuasa T, Maezawa K, Kaneko K, Nozawa M (2017) Rotational acetabular osteotomy for acetabular dysplasia and osteoarthritis: a mean follow-up of 20 years. Arch Orthop Trauma Surg 137:465–469.  https://doi.org/10.1007/s00402-017-2636-8 CrossRefGoogle Scholar
  23. 23.
    Lack W, Windhager R, Kutschera HP, Engel A (1991) Chiari pelvic osteotomy for osteoarthritis secondary to hip dysplasia. Indications and long-term results. J Bone Joint Surg Br 73:229–234CrossRefGoogle Scholar
  24. 24.
    Chougle A, Hemmady MV, Hodgkinson JP (2006) Long-term survival of the acetabular component after total hip arthroplasty with cement in patients with developmental dysplasia of the hip. J Bone Joint Surg Am 88:71–79.  https://doi.org/10.2106/JBJS.D.02689 Google Scholar
  25. 25.
    Migaud H, Putman S, Berton C, Lefevre C, Huten D, Argenson J-N, Gaucher F (2014) Does prior conservative surgery affect survivorship and functional outcome in total hip arthroplasty for congenital dislocation of the hip? A case-control study in 159 hips. Orthop Traumatol Surg Res 100:733–737.  https://doi.org/10.1016/j.otsr.2014.07.016 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Lauren J. Seo
    • 1
  • Jonathan Gabor
    • 1
  • David Novikov
    • 1
  • James E. Feng
    • 1
  • Ran Schwarzkopf
    • 1
  • Jonathan M. Vigdorchik
    • 1
    Email author
  1. 1.Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint ReplacementHospital for Special SurgeryNew YorkUSA

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