Total hip arthroplasty with no femoral shortening osteotomy for unilateral Crowe Ⅳ developmental dysplasia of the hip / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical efficacy of total hip arthroplasty (THA) with no femoral shortening oste?otomy for unilateral CroweⅣ developmental dysplasia of hip. Methods From October 2007 to January 2010, 32 patients with CroweⅣdevelopmental dysplasia of hip in one side underwent THA, including 20 females and 12 males, with an average age of 49.4 ± 9.7 years (range, 23-60 years). There were 15 cases as normal and 17 as mild developmental dysplasia of hip in the other side. The THA were performed with requisite soft tissue release and direct leverage using an elevator but with no femoral shorten?ing osteotomy. The patients' satisfaction, Harris hip score, bilateral leg?length discrepancy and pelvic obliquity was used to assess the clinical results. Results All of patient were followed up for 1-6 years, average 4.0 ± 1.5 years. No loosening or failure of component occurred by the end of follow?up. The Harris hip score was improved from preoperative 36.5±10.3 (20-63) to 89.8± 4.9 (80-97), and the excellent and good rate was 100% (excellent 16 cases, good 16 cases). The satisfactory rate was 93.8%(30/32). The leg?length discrepancy of the bilateral sides and the pelvic obliquity was corrected gradually and the gait returns to normal. Nine cases have valgus knee after THA and 4 cases of them felt uncomfortable after long?distance walk. Femoral nerve injury occurred in 2 cases. All of cases recovered after 1 and 3 months respectively. No infection and dislocation oc?curred. Conclusion THA with no femoral shortening osteotomy can achieve good clinical results in patients with unilateral CroweⅣdevelopmental dysplasia of hip. The discrepancy of leg?length will be diminished with the correction for pelvic obliquity.