The dysplastic hip: not for the shallow surgeon.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Developmental hip dysplasia often involves complex acetabular and femoral deformities.
• Pre-operative planning for total hip replacement in these cases is challenging.

Purpose of the Study:

• To highlight the challenges in total hip replacement for developmental hip dysplasia.
• To emphasize the limitations of the Crowe classification for surgical planning.
• To outline essential considerations for successful surgical outcomes.

Main Methods:

• Review of challenges in total hip replacement for developmental hip dysplasia.
• Discussion of the inadequacy of the Crowe classification for pre-operative planning.
• Emphasis on the need for adaptable surgical techniques and implants.

Main Results:

• The Crowe classification is insufficient for detailed pre-operative planning in developmental hip dysplasia.
• Availability of small acetabular components, acetabular augments, and modular femoral components is crucial.
• Surgeons must anticipate the need for femoral osteotomy to address shortening, rotation, or angulation.

Conclusions:

• Total hip replacement for developmental hip dysplasia requires meticulous planning and a versatile surgical approach.
• Standardized classification systems may not adequately prepare surgeons for the anatomical variations encountered.
• A comprehensive set of implants and readiness for corrective osteotomies are vital for managing these complex cases.