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Published on: September 7, 2022
[Total hip arthroplasty for Crowe type-IV development dysplasia of hip in adults]
Zhen-an Zhu1, Ke-rong Dai, You Wang
1Department of Orthopaedics, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China. zhuzhenan2006@126.com
Objective:
To determine the operation procedure of total hip arthroplasty (THA) for Crowe type-IV developmental dysplasia of hip and its relationship with nerve injury.
Methods:
A consecutive series of 39 THAs was performed for Crowe type-IV developmental dysplasia of hip in 35 patients (all female). The mean age of the patients at the time of surgery was 46 years (range 36 - 56 years). Thirty-five hips in 31 patients were followed up. The average follow-up period of the whole series was 4 years (range 1 - 8 years). All procedures were carried out through a lateral-posterior approach. In 33 of 35 hips, the cup was inserted in the "true" acetabulum. All the prostheses used were cementless, except for 5 cemented femoral stems in 5 patients. Each patient was evaluated clinically and by radiographs before the operation and during the follow-up period, according to the Harris hip score (HHS).
Results:
None of the cups and stems were revised for aseptic loosening, dislocation or infection during the follow-up period. The mean preoperative HHS was 43 compared with the postoperative HHS of 87. The mean amount of postoperative leg lengthening was 5 cm (range 4 - 6 cm).
Conclusions:
The reconstruction of the hip at the level of the "true" acetabulum through a lateral-posterior approach is a safe and effective procedure of THA for Crowe type-IV developmental dysplasia of hip in adults. Acute leg lengthening of less than 6 cm could not cause nerve injury.