Total hip arthroplasty with soft tissue release for patients with severe development dysplasia of the hip / 中南大学学报(医学版)

Objective:To explore the clinical effect of total hip replacement with soft tissue release and true acetabulum reconstruction on treating osteoarthritis secondary to severe development dysplasia of the hip.Methods:From January 2005 to January 2011,23 hips in 21 patients with osteoarthritis secondary to Crowe Ⅲ development dysplasia of the hip underwent total hip arthroplasty with soft tissue release and true acetabulum reconstruction.There were 18 females and 3 males.The age was (45.1±13.2) years.Two patients underwent bilateral total hip arthroplasty (THA) and 19 cases underwent unilateral hip.The Harris hip score was 39.7±5.6.Results:The duration of follow up was (110±46) months.The symptoms of patients were relieved,and all the patients' femur head recovered to the true acetabulum after soft tissue released.Sciatic nerve paralysis occurred in one patient,who recovered after 3 months.All patients showed restoration of limb length,while the limb-length discrepancy was (11.0±3.5) mm.The postoperation Harris hip score was 87.2±5.9.Conclusion:Total hip arthroplasty with soft tissue release and true acetabulum reconstruction was an effective method in treating osteoarthritis secondary to Crowe Ⅲ development dysplasia of the hip and was a challenging work to the orthopedic surgeon.It was critical the surgeon to plan the operative intervention carefully.

Effect of abducens orthosis combined with walker on developmental dysplasia of the hip / 中南大学学报(医学版)

Objective To evaluate the effect of abducens orthosis combined with walker on de-velopmental dysplasia of the hip ( DDH ). Methods A total of 126 patients (224 hips ) with DDH aged 6～36 months in Xiangya Hospital was randomly divided into 2 groups: an orthosis combined with walker group and an improved hip frog cast fixation group. Seventy patients (130 hips) were treated by the orthosis combined with walker and 56 patients (94 hips) were treated by the improved hip frog cast fixation. We compared the effect and complications of the 2 groups. Results The fine-ness rates of the orthosis combined with walker group and the improved hip frog cast fixation group were 89.2% and 90.4% , respectively, with no significant difference (P>0.05). The rate of femoral head osteonecrosis in the orthosis combined with walker group was significantly lower than that in the improved hip frog cast fixation group (1.5 % vs. 5.3 % , P<0.05) , but the re-dislocation rate in the former was significantly higher than that in the latter (6.9 % vs. 1.1% , P<0.05). Conclusion Both methods are effective for DDH. Orthosis combined with walker has a lower propor-tion of femoral head osteonecrosis, but a higher proportion of re-dislocation.