Alumina-on-alumina hip replacement in developmental dysplasia of the hip

Total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH) requires complex reconstructive techniques and presents an increased risk of complications. Because of these patients' young age, alternative bearing surfaces such as alumina-on-alumina couples could be an option. We asked whether moderate or severe congenital dysplasia of the hip would influence the clinical outcome and rates of cup loosening in our patients. We prospectively compared 50 hips in patients with dysplastic hip (group 1) and 22 hips in patients with a low or high dislocation (group 2) using an alumina-on-alumina THA. The minimum follow-up was 5 years (range 5-10 years). Age, activity level, and implant size were greater in group 1. Preoperative function and range of mobility were worse in group 2. The survival rate for cup loosening at 5 years was 89.8% (95% confidence interval, 78.7%-100%) for group 1 and 81.7% (95% confidence interval, 57.6%-100%) for group 2. An alumina-on-alumina THA provides a high level of pain relief and functional improvement in hip dysplasia. Continued follow-up will be required to determine if the alumina-on-alumina bearings in these patients result in less osteolysis and loosening.