CEMENTLESS TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE Ⅲ DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHAOYunhong , YANGYi ,  LIBiao , YANGLiu , LUQiuan , GONGYuekun , YANGJia , ZHANGZhengxue

Department of Orthopaedics, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650000, P. R. China;

Corresponding author：

LIBiao, Email: libiao0012010@163.com

Keywords：

Developmental dysplasia of hip; Total hip arthroplasty; Crowe type Ⅲ; Adult

DOI：

10.7507/1002-1892.20160192

Video：

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Objective To investigate the value of cementless total hip arthroplasty (THA) for the treatment of Crowe type Ⅲ developmental dysplasia of hip (DDH) in adults. Methods Between September 2013 and September 2015, 50 patients (51 hips) with Crowe type Ⅲ DDH were treated. There were 20 males (20 hips) and 30 females (31 hips), with the average age of 39 years (range, 19-55 years). The left side was involved in 34 cases, the right side in 15 cases, and both sides in 1 case. All patients had the symptoms of limp walking and hip pain. The disease duration was 10-47 months (mean, 26 months). The sign of "4" number test and Trendenleburg sign were positive; the Harris score was 38.9±7.1. The bilateral lower extremities discrepancy was 2.5-4.0 cm (mean, 3.3 cm) before operation. All the patients underwent cementless THA, and acetabulum by structural femoral head autograft was performed in 28 cases (28 hips). Results After operation, the incision healed by first intention. Only 2 patients (2 hips) had femoral nerve palsy, and 7 patients (7 hips) had leg swelling, which were cured after symptomatic treatment. All the patients were followed up 6-18 months (mean, 10 months). The sign of limp walking was improved after operation, hip pain was relieved in 46 patients (46 hips) and only 4 patients (5 hips) still had mild pain. The X-ray films showed bony healing at 3-6 months (mean, 5 months) after operation. At last follow-up, the patients had equal limb length with the discrepancy less than 1 cm (mean, 0.4 cm). At last follow-up, the Harris score was significantly increased to 91.2±2.8 (t=-79.77, P=0.00). Conclusion The cementless THA is an effective method to treat Crowe type Ⅲ DDH in adults.

Citation： ZHAOYunhong, YANGYi, LIBiao, YANGLiu, LUQiuan, GONGYuekun, YANGJia, ZHANGZhengxue. CEMENTLESS TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE Ⅲ DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(8): 947-950. doi: 10.7507/1002-1892.20160192 Copy

1.	Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type IV developmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
2.	李彪, 龚跃昆, 张磊, 等.生物型全髋关节置换术治疗成人髋关节发育不良.中国修复重建外科杂志, 2008, 22(6):646-648.
3.	Yoon PW, Kim JI, Kim DO, et al. Cementless total hip arthroplasty for patients with Crowe typeⅢ or IV developmental dysplasia of the hip:two-stage total hip arthroplasty following skeletal traction after soft tissue release for irreducible hips. Clin Orthop Surg, 2013, 5(3): 167-173.
4.	Rogers BA, Garbedian S, Kuchinad RA, et al. Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg (Am), 2012, 94(19):1809-1821.
5.	Antoniades J, Pellegrini VD Jr. Cross-sectional anatomy of the illum:implications for acetabular compoment placement in total hip arthroplasty. Clin Orthop Relat Res, 2012, 470(12):3537-3541.
6.	Moskal JT, Capps SG, Scanelli JA. Improving the accuracy of acetabular component orientation:avoiding malpositioning:AAOS exhibit selection. J Bone Joint Surg (Am), 2013, 95(11):e761.
7.	Terjesen T, Horn J, Gunderson RB. Fifty-year follow-up of latedetected hip dislocation:clinical and radiographic outcomes for seventy-one patients treated with traction to obtain gradual closed reduction. J Bone Joint Surg (Am), 2014, 96(4):e28.
8.	Fukui K, Kaneuji A, Sugimori T, et al. How far above the true anatomic position can the acetabular cup be placed in total hip arthroplasty? Hip Int, 2013, 23(2):129-134.
9.	Gustke K. The dysplastic hip:not for the shallow surgeon. Bone Joint J, 2013, 95-B (11 Suppl A):31-36.
10.	Ito H, Matsuno T, Minami A, et al. Intermediate-term results after hybrid total hip arthroplasty for the treatment of dysplastic hips. J Bone Joint Surg (Am), 2003, 85-A(9):1725-1732.
11.	Kobayashi S, Satio N, Nawata M, et al. Total hip arthroplasty with bulk femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip. J Bone Joint Surg (Am), 2003, 85-A(4):615-621.
12.	Hartofilakidis G, Georgiades G, Babis GC, et al. Evaluation of two surgical techniques for acetabular reconstruction in total hip replacement for congenital hip disease:results after a minimum tenyear follow-up. J Bone Joint Surg (Br), 2008, 90(6):724-730.
13.	Zhu J, Chen X, Cui Y, et al. Mid-term results of Bernese periacetabular osteotomy for developmental dysplasia of hip in middle aged patients. Int Orthop, 2013, 37(4):589-594.
14.	Bao N, Meng J, Zhou L, et al. Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip. Int Orthop, 2013, 37(3):385-390.
15.	Hartoflakidis G, Karachalios T. Total hip arthroplasty for congential hip disease. J Bone Joint Surg (Am), 2004, 86-A(2):242-250.
16.	Neumann D, Thaler C, Dorn U. Femoral shortening and cementless arthroplasty in Crowe type 4 congenital dislocation of the hip. Int Orthop, 2012, 36(3):499-503.
17.	Krych AJ, Howard JL, Trousdale RT, et al. Total hip arthroplasty with shortening sunbtrochanteric osteotomy in Crowe type-IV developmental dysplasia. J Bone Joint Surg (Am), 2009, 91(9):2213-2221.
18.	Yan F, Chen G, Yang L, et al. A reduction technique of arthroplasty without subtrohanteric femoral shortening osteotomy for the treatment of developmental high dislocation of hip:a case of 28 hips. J Arthroplasty, 2014, 29(12):2289-2293.

1. Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type IV developmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
2. 李彪, 龚跃昆, 张磊, 等.生物型全髋关节置换术治疗成人髋关节发育不良.中国修复重建外科杂志, 2008, 22(6):646-648.
3. Yoon PW, Kim JI, Kim DO, et al. Cementless total hip arthroplasty for patients with Crowe typeⅢ or IV developmental dysplasia of the hip:two-stage total hip arthroplasty following skeletal traction after soft tissue release for irreducible hips. Clin Orthop Surg, 2013, 5(3): 167-173.
4. Rogers BA, Garbedian S, Kuchinad RA, et al. Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg (Am), 2012, 94(19):1809-1821.
5. Antoniades J, Pellegrini VD Jr. Cross-sectional anatomy of the illum:implications for acetabular compoment placement in total hip arthroplasty. Clin Orthop Relat Res, 2012, 470(12):3537-3541.
6. Moskal JT, Capps SG, Scanelli JA. Improving the accuracy of acetabular component orientation:avoiding malpositioning:AAOS exhibit selection. J Bone Joint Surg (Am), 2013, 95(11):e761.
7. Terjesen T, Horn J, Gunderson RB. Fifty-year follow-up of latedetected hip dislocation:clinical and radiographic outcomes for seventy-one patients treated with traction to obtain gradual closed reduction. J Bone Joint Surg (Am), 2014, 96(4):e28.
8. Fukui K, Kaneuji A, Sugimori T, et al. How far above the true anatomic position can the acetabular cup be placed in total hip arthroplasty? Hip Int, 2013, 23(2):129-134.
9. Gustke K. The dysplastic hip:not for the shallow surgeon. Bone Joint J, 2013, 95-B (11 Suppl A):31-36.
10. Ito H, Matsuno T, Minami A, et al. Intermediate-term results after hybrid total hip arthroplasty for the treatment of dysplastic hips. J Bone Joint Surg (Am), 2003, 85-A(9):1725-1732.
11. Kobayashi S, Satio N, Nawata M, et al. Total hip arthroplasty with bulk femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip. J Bone Joint Surg (Am), 2003, 85-A(4):615-621.
12. Hartofilakidis G, Georgiades G, Babis GC, et al. Evaluation of two surgical techniques for acetabular reconstruction in total hip replacement for congenital hip disease:results after a minimum tenyear follow-up. J Bone Joint Surg (Br), 2008, 90(6):724-730.
13. Zhu J, Chen X, Cui Y, et al. Mid-term results of Bernese periacetabular osteotomy for developmental dysplasia of hip in middle aged patients. Int Orthop, 2013, 37(4):589-594.
14. Bao N, Meng J, Zhou L, et al. Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip. Int Orthop, 2013, 37(3):385-390.
15. Hartoflakidis G, Karachalios T. Total hip arthroplasty for congential hip disease. J Bone Joint Surg (Am), 2004, 86-A(2):242-250.
16. Neumann D, Thaler C, Dorn U. Femoral shortening and cementless arthroplasty in Crowe type 4 congenital dislocation of the hip. Int Orthop, 2012, 36(3):499-503.
17. Krych AJ, Howard JL, Trousdale RT, et al. Total hip arthroplasty with shortening sunbtrochanteric osteotomy in Crowe type-IV developmental dysplasia. J Bone Joint Surg (Am), 2009, 91(9):2213-2221.
18. Yan F, Chen G, Yang L, et al. A reduction technique of arthroplasty without subtrohanteric femoral shortening osteotomy for the treatment of developmental high dislocation of hip:a case of 28 hips. J Arthroplasty, 2014, 29(12):2289-2293.

Chinese Journal of Reparative and Reconstructive Surgery

CEMENTLESS TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE Ⅲ DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS

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