Clinical application of total hip arthroplasty with a short-neck and straight stem for treatment of developmental dysplastic hip with high dislocation / 中国矫形外科杂志

ABSTRACT

[Objective] To evaluate clinical effect of total hip arthroplasty(THA)with a short-neck and straight stem in patients with osteoarthritis secondary to developmental dysplastic hip with high dislocation.[Methods]From June 2002 to October 2007,total hip arthroplasties with a short-neck and straight stem were performed for 11 patients(12 hips)with osteoarthritis secondary to developmental dysplastic hip with high dislocation.All were females with an average age of 51 years(range from 41 to 68 years).The operations were performed through a posterolateral approach.All the acetabular cups were reconstructed at the original anatomic location,and structural autogenous bone-grafting was performed if the cup was not covered enough by host bone.Short-neck and straight femoral stems were used with cement fixation.During operation,the soft tissue around hip was released extensively.[Results]After surgery,the center of the hip had an average distal translation of 4.5cm(range from 3.8 to 4.8 cm)and the limb length had an average increase of 3.9cm(range from 3.6 to 4.3 cm).All the patients were followed up for a mean time of 36 months(range from 10 to 66 months).All structural autografts united and none of acetabular and femoral components showed loosening.No radiolucent line was observed at the bone-cement and at the implant-cement interface around femoral stem.No patient had sciatic or femoral nerve palsy.The mean Harris score increased from preoperative 41.8 points to postoperative 86.2 points.[Conclusion]THA with a short-neck and straight stem for treatment of osteoarthritis secondary to developmental dysplastic hip with high dislocation avoids femoral shortening osteotomy and greater trochanter osteotomy when the center of hip had a distal translation less than 5cm in preoperative plan,and this choice provides satisfactory results at early-term follow-up.