Total hip Replacement in Crowe type IV dysplastic hips - average 5 year follow-up and literature review

Area of Science:

• Orthopedic Surgery
• Radiology
• Rheumatology

Background:

• Developmental Dysplasia of the Hip (DDH) can lead to severe osteoarthritis in dysplastic hips.
• Crowe grade IV represents the most severe form of hip dislocation, posing significant surgical challenges.

Purpose of the Study:

• To evaluate the outcomes of Total Hip Replacement (THR) in patients with Crowe grade IV dysplastic hips.
• To assess radiological parameters and clinical outcomes following THR for osteoarthritis secondary to DDH.

Main Methods:

• Retrospective study of 29 patients (34 hips) with Crowe grade IV dysplastic hips.
• Radiological evaluation included Sharp's acetabular angle, cup inclination, loosening, and ectopic bone formation.
• Clinical outcomes were assessed using pre- and postoperative Harris hip scores and leg length discrepancy.

Main Results:

• Preoperative mean acetabular angle was 60.8°. Subtrochanteric femoral osteotomy was performed in 18 hips.
• Mean preoperative leg length discrepancy was 5 cm, with correction within 1 cm achieved in most patients.
• Mean Harris hip score improved from 40.80 preoperatively to 87.96 postoperatively.

Conclusions:

• Total hip replacement (THR) is a successful surgical option for managing severe hip dysplasia (Crowe grade IV).
• While THR demonstrates efficacy, individualized treatment approaches are crucial due to the complexity of these cases.
• The study highlights the potential for significant functional improvement and correction of leg length discrepancy in patients with severe DDH undergoing THR.