[Short-term effectiveness of visual treatment solution-assisted treatment for Crowe type Ⅲ- Ⅳ developmental dysplasia...

To evaluate the short-term effectiveness of a visual treatment solution (VTS)-assisted total hip arthroplasty (THA) in patients with Crowe type Ⅲ-Ⅳ developmental dysplasia of the hip (DDH).

A retrospective analysis was conducted on the clinical data of 43 patients with Crowe type Ⅲ-Ⅳ DDH who were treated between June 2023 and December 2024 and met the eligibility criteria. Of these, 22 patients underwent conventional THA (traditional group), and 21 underwent VTS-assisted THA (VTS group). There was no significant difference ( P>0.05) between the two groups in baseline data, including gender, age, side, Crowe classification, preoperative visual analogue scale (VAS) score, or Harris score. The operation time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and postoperative complications were recorded and compared between the two groups. Functional recovery and pain relief were assessed using the Harris score preoperatively and at 1 week, 3 months, and 6 months postoperatively, as well as the VAS score preoperatively and at 1 week and 1 month postoperatively. The acetabular cup anteversion and abduction angles were measured, and cup position was assessed with reference to the Lewinnek safe zone. Limb length discrepancy was measured, and acetabular coverage as well as the matching rates between the preoperatively planned and actually implanted prosthesis sizes were calculated.

The operation time, intraoperative blood loss, and postoperative drainage volume were all significantly lower in the VTS group than in the traditional group ( P<0.05), whereas no significant difference was found in length of hospital stay ( P>0.05). All patients were followed up 6-9 months, with a mean time of 7.4 months. Primary wound healing was achieved in both groups, and no poor wound healing or neurovascular injury occurred. Deep venous thrombosis developed in 2 patients in the VTS group and 4 patients in the traditional group; 1 patient in the traditional group experienced prosthetic dislocation. No other complication, including dislocation or thrombosis, was observed during follow-up. There was no significant difference in the overall complication incidence between the two groups ( P>0.05). In both groups, acetabular anteversion and abduction angles were within the Lewinnek safe zone, but their distributions were more concentrated in the VTS group than in the traditional group. Compared with the traditional group, the VTS group showed significantly smaller postoperative limb length discrepancy and significantly greater anteversion angle and acetabular coverage ( P<0.05). No significant difference was found between the two groups in abduction angle, acetabular prosthesis matching rate, or femoral stem prosthesis matching rate ( P>0.05). Harris scores at 3 and 6 months postoperatively and VAS scores at 1 week and 1 month postoperatively were significantly better in the VTS group than in the traditional group ( P<0.05), whereas no significant difference was observed at the other time points ( P>0.05).

VTS-assisted THA for Crowe type Ⅲ-Ⅳ DDH yields favorable short-term effectiveness by improving implant positioning accuracy, reducing surgical trauma, and promoting early pain relief and functional recovery.