[Total hip arthroplasty in the treatment of arthrosis with coexistent high developmental hip dislocation]

The question if total hip arthroplasty ought to be advised for patients with high developmental hip dislocation is still actual. The subject of hip arthroplasty, as a method of surgical treatment of high developmental hip dislocation, was analyzed on the base of follow up of seven patients, who underwent this procedure. The mean age of patients was 44.5 (+/- 12.6) years. The mean time of follow up was 64.4 (21.6) months. Initial three patients were treated in two stage regime. In first stage, a surgical hip liberalization and skeletal traction through 3 weeks was performed. In 2nd stage we did total hip replacement with simultaneous shortening of the femoral shaft just below the lesser trochanter. In next four patients we performed total hip arthroplasty with simultaneous shortening of the femoral shaft in one stage. Protection of undesirable rotational instability after osteotomy was done by means of different ways of osteotomy fixation describe in paper. Applied surgical treatment allowed for implanting a cup of prosthesis in original place of acetabulum and reduction of the big anteversion of the femoral neck. The hip congruency was improved in all patients. Score in functional Harris hip scale increased from mean value of 50 points before hip arthroplasty to mean value of 85 points after surgery. The symptoms of late consolidation of osteotomy were observed in one patient with transverse osteotomy without anty-rotational fixation. Total hip replacement with simultaneous "Z" shortening osteotomy of the femoral shaft give good such clinical as radiological results in the treatment of hip osteoarthritis in accordance to high developmental hip dislocation.