Total hip arthroplasty for crowe type IV developmental dysplasia of the hip using a dual mobility acetabular cup

This study aims to evaluate the effectiveness of total hip arthroplasty (THA) with subtrochanteric femoral osteotomy in patients with Crowe type IV DDH in terms of functional outcomes, complication rates, and implant stability. The study was prospective, conducted in the University Clinical Center of Kosovo and Otrila Hospital from 2016 to 2022 and included 22 patients with Crowe type IV hip dysplasia who underwent the THA with a subtrochanteric femoral osteotomy procedure. The treatment was performed using the posterior approach, and the placement of the dual mobility acetabular cup was based on the anatomic hip center using a Quattro non-cemented endoprothesis. There were no reported hip dislocations, and all patients had a negative Trendelenburg sign at approximately 6 months post-surgery. Harris Hip Score (HHS) and Functional Independent Score (FIS) were significantly increased after the treatment (t = 21.342, p < 0.0001; and t = 83.331, p < 0.0001, respectively). The limb-length discrepancy decreased significantly after surgery (Mean = 0.7 cm) compared to pre-surgery (Mean = 3.5 cm) (p < 0.05). The study concludes that THA with subtrochanteric osteotomy is a safe and effective treatment option for Crowe type IV hip dysplasia. Using dual mobility acetabular components and compression in the osteotomy led to improved outcomes and faster recovery. It can restore the anatomic hip center and improve functional outcomes while reducing the risk of dislocation.