Congenital dislocation of the hip treated by total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Hip Arthroplasty

Background:

• Congenital dislocation of the hip (CDH) can lead to severe incapacitation and pain in adults.
• Traditional treatments may not fully restore function or alleviate pain in advanced cases.
• Acetabular dysplasia associated with CDH poses surgical challenges for total hip arthroplasty (THA).

Purpose of the Study:

• To evaluate the efficacy of total hip arthroplasty (THA) in severely incapacitated adult patients with congenital dislocation of the hip (CDH).
• To assess the outcomes of using femoral head autografts to augment the acetabulum during THA for CDH.
• To determine the long-term functional and radiological results of this surgical technique.

Main Methods:

• Retrospective analysis of 32 total hip arthroplasties (THAs) performed on 26 adult patients with severe CDH.
• Surgical technique involved placing the acetabular cup in the true acetabulum, with femoral head autografts used in 19 cases.
• Patients were evaluated based on functional outcomes, pain levels, and radiological assessment of bone grafts.

Main Results:

• Overall satisfactory results were achieved, with 19 patients experiencing a return to normal life and 5 showing minimal incapacitation.
• Radiological evaluation confirmed no nonunion or secondary displacement of the femoral head autografts.
• Only two patients reported no improvement following the operation.

Conclusions:

• Total hip arthroplasty (THA), particularly when combined with acetabular deepening using autogeneic bone grafts, is a highly effective treatment for severe congenital dislocation of the hip in adults.
• The procedure demonstrates good functional recovery and graft incorporation, making it a recommended option for alleviating pain and restoring mobility.
• This surgical strategy offers a viable solution for previously invalid patients suffering from painful hip dysplasia.