Abstract
Developmental dysplasia is a relatively common condition seen in all parts of the world. Untreated and inadequately treated Developmental Dysplasia of Hip (DDH) of childhood presents as secondary arthritis in the third and fourth decades of life. Total hip arthroplasty is the only reliable option if the arthritis is advanced. The acetabulum and femur have distinctive abnormalities, which must be recognized by the surgeon and dealt with appropriately. On the socket side, most dysplastic hips can be handled by modified reaming technique, which takes the underlying patho-anatomy into account. It is ideal to place the uncemented socket in the best available bone that is at a higher level than native in Crowe 1–3 types of hip dysplasia. On the femoral side, anteversion and coxa valga are managed by using implants that have rotational and supero-inferior freedom. In high-riding hips (Crowe 4), the best bone stock is in the native center where the cup is placed and the femur invariably requires a subtrochanteric shortening osteotomy. The functional outcomes of total hip arthroplasty (THA) in DDH are very good but higher complication rates have been reported.
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References
McCarthy JC, Noble PC, Villar RN. Hip joint restoration, worldwide advances in arthroscopy, arthroplasty, osteotomy and joint preservation surgery. Springer; 2017. https://doi.org/10.1007/978-1-4614-0694-5.
Lodhia P, Chandrasekaran S, Gui C, Darwish N, Suarez-Ahedo C, Domb BG. Open and arthroscopic treatment of adult hip dysplasia: a systematic review. Arthroscopy. 2016;32(2):374–83. https://doi.org/10.1016/j.arthro.2015.07.022.
Bernasek TL, Gustke KA. CT analysis of 100 Japanese patient with DDH. Philadelphia, PA: Poster session presented at: Biomedical Engineering Society Philadelphia; 2004.
Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint: with special reference to the complication of osteoarthritis. Acta Chir Scand. 1939;83(Suppl 58):1–135.
Shah A, Kay J, Memon M, et al. Clinical and radiographic predictors of failed hip arthroscopy in the management of dysplasia: a systematic review and proposal for classification. Knee Surg Sports Traumatol Arthrosc. 2019;28:1296. https://doi.org/10.1007/s00167-019-05416-3.
Kraeutler MJ, Goodrich JA, Ashwell ZR, Garabekyan T, Jesse MK, Mei-Dan O. Combined lateral osseolabral coverage is normal in hips with acetabular dysplasia. Arthroscopy. 2019;35(3):800–6.
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.
Yang Y, Zuo J, Liu T, Xiao J, Liu S, Gao Z. Morphological analysis of true acetabulum in hip dysplasia (Crowe Classes I–IV) via 3-D implantation simulation. J Bone Joint Surg Am. 2017;99:e92.
Shi X, Li C, Cheng C, Feng C, Li S, Liu J. Preoperative planning for total hip arthroplasty for neglected developmental dysplasia of the hip. Orthop Surg. 2019;11(3):348–55. https://doi.org/10.1111/os.12472.
Delp SL, Wixson RL, Komattu AV, et al. How superior placement of the joint center in hip arthroplasty affects the abductor muscles. Clin Orthop Relat Res. 1996;328:137–46.
Dearborn JT, Harris WH. High placement of an acetabular component inserted without cement in a revision total hip arthroplasty. Results after a mean of ten years. J Bone Joint Surg Am. 1999;81:469–80.
Nawabi DH, Meftah M, Nam D, et al. Durable fixation achieved with medialized, high-hip center cementless THAs for Crowe II and III dysplasia. Clin Orthop Relat Res. 2014;472:630–6.
Kaneuji A, Sugimori T, Ichiseki T, et al. Minimum ten-year results of a porous acetabular component for Crowe I to III hip dysplasia using an elevated hip center. J Arthroplast. 2009;24:187–94.
Murayama T, Ohnishi H, Okabe S, et al. 15-year comparison of cementless total hip arthroplasty with anatomical or high cup placement for Crowe I to III hip dysplasia. Orthopedics. 2012;35:e313–8.
Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ. Total hip arthroplasty with shorthening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia: surgical technique. J Bone Joint Surg Am. 2009;91(9):2213–21.
Liu R, Li Y, Fan L, Mu M, Wang K, Song W. Depression and anxiety before and after limb length discrepancy correction in patients with unilateral developmental dysplasia of the hip. J Psychosom Res. 2015;79:574–9.
Pagnano W, Hanssen AD, Lewallen DG, Shaughnessy WJ. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am. 1996;78(7):1004–14.
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Bose, V.C., Kanniyan, K., Muttathupadam, A. (2023). Total Hip Arthroplasty in Dysplastic Hips. In: Sharma, M. (eds) Hip Arthroplasty. Springer, Singapore. https://doi.org/10.1007/978-981-99-5517-6_17
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DOI: https://doi.org/10.1007/978-981-99-5517-6_17
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