'THA for DDH: replacement principles and techniques - femoral side'

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Radiology

Background:

• Developmental dysplasia of the hip (DDH) is a primary cause of early hip osteoarthritis.
• DDH presents significant surgical challenges in total hip arthroplasty.
• Current classifications overlook critical femoral morphological variations impacting surgical planning.

Purpose of the Study:

• To highlight the importance of femoral morphological variations in DDH.
• To emphasize comprehensive preoperative planning for DDH total hip arthroplasty.
• To review current surgical strategies and implant options for DDH.

Main Methods:

• Review of existing literature on DDH and hip arthroplasty.
• Analysis of femoral morphological characteristics in DDH.
• Evaluation of surgical techniques and implant choices for DDH.

Main Results:

• Dysplastic femora exhibit unique anatomical variations (e.g., anteversion, neck-shaft angle, canal morphology).
• These variations necessitate tailored surgical planning, including implant selection and potential osteotomies.
• Both cemented and cementless stems can be effective, with specialized designs for severe deformities.

Conclusions:

• Comprehensive preoperative assessment, including femoral morphology, is vital for successful DDH total hip arthroplasty.
• Femoral shortening osteotomies, particularly subtrochanteric, are effective for severe DDH.
• Further research into proximal femur morphology is needed to optimize surgical outcomes.