TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE IV CONGENITAL DYSPLASIA OF HIP WITH DISLOCATION IN ADULTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Wenbo , ZHANG Wenming , BAI Guochang , HUANG Zida , SHEN Rongkai.

Department of Orthopedics, Affiliated First Hospital of Fujian Medical University, Fuzhou Fujian, 350001, P.R.China. Corresponding author: ZHANG Wenming, E-mail: zhangwm0591@163.com;

Corresponding author：

Keywords：

Congenital dysplasia of the hip; Hip dislocation; Total hip arthroplasty

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Objective To study the effectiveness and acetabular prosthesis selection of the total hip arthroplasty (THA) for Crowe type IV congenital dysplasia of the hip with dislocation in adults. Methods Between June 2008 and May 2012, 8 adult patients (8 hips) with Crowe type IV congenital dysplasia of the hip with dislocation underwent THA. They were all female, aged 20-35 years with a mean age of 25 years. The left hip was involved in 5 cases and the right hip in 3 cases. The Harris score of involved hip was 53.9 ± 6.6. The shortened length of involved extremity was 4-6 cm (mean, 4.8 cm). The X-ray films showed complete dislocation in all cases. The acetabular prosthesis with diameter of 42-44 mm and S-ROM femoral prosthesis were used in THA. Results The incisions healed by first intention. There was no hip dislocation events and sciatic nerve injury during the follow-up. Femoral nerve injury occurred in 1 case and asymptomatic venous thrombosis of the leg muscle occurred in 2 cases. All the patients were followed up 1-5 years (mean, 3 years). All cases showed obvious improvement of claudication and could restore to work. At 6 months after operation, the mean length difference between affected and contralateral extremities was 0.4 cm (range, — 1.0-0.6 cm); the Harris score was significantly increased to 87.6 ± 0.3 (t=1.77, P=0.00). The X-ray films showed that all cases got bony union at 3-6 months after operation and stable interface between acetabular prosthesis and bone. No revision was involved during the follow-up. Conclusion THA with small acetabular cup and subtrochanteric osteotomy is an effective method in the treatment of Crowe type IV congenital dysplasia of the hip with dislocation in adults. The early effectiveness is satisfactory. The long-term survival rate of prosthesis needs to be followed up.

Citation： LI Wenbo,ZHANG Wenming,BAI Guochang,HUANG Zida,SHEN Rongkai.. TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE IV CONGENITAL DYSPLASIA OF HIP WITH DISLOCATION IN ADULTS. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(10): 1153-1156. doi: Copy

1.	Gee MJ, Ajuied A, Shah Z, et al. Systematic review of total hip arthroplasty in patients under 30 years old. Hip Int, 2013. [Epub ahead of print].
2.	Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1): 15-23.
3.	Cameron HU, Botsford DJ, Park YS. Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty, 1996, 11(5): 582-587.
4.	Noble PC, Kamaric E, Sugano N, et al. Three-dimentional shape of the dysplastic femur: implications for THR. Clin Orthop Relat Res, 2003, (417): 27-40.
5.	Christie M, Brinson MF. Proximal/distal mismatch: type A and C femurs. Orthopedics, 2005, 28(9 Suppl): s1033-1036.
6.	Bruce WJ, Rizkallall SM, Kwon YM, et al. A new technique of subtrochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. J Arthroplasty, 2000, 15(5): 617-626.
7.	Dapuzzo MR, Sierra RJ. Acetabular considerations during total hip arthroplasty for hip dysplasia. Orthop Clin North Am, 2012, 43(3): 369-375.
8.	Tsukada S, Wakui M. Bulk femoral head autograft without decortication in uncemented total hip arthroplasty: seven- to ten-year results. J Arthroplasty, 2012, 27(3): 437-444.
9.	Rozkydal Z, Smid Z, Kristek J. Structural bone grafting in THR with cup for dysplastic hip. Acta Chir Orthop Traumatol Cech, 2000, 67(5): 298-306.
10.	Somferd MP, Bolder SB, Gardeniers JW, et al. Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips. Clin Orthop Relat Res, 2008, 466(2): 359-365.
11.	Linde F, Jermen J, Pilgaard S. Charnley arthroplasty in osteoarthritis secondary to congenital dislocation or subluxation of the hip. Clin Orthop Relat Res, 1988, (227): 164-171.
12.	康鹏德, 杨静, 沈彬, 等. CroweⅣ型髋关节发育不良全髋关节置换术前计算机辅助设计. 中华骨科杂志, 2012, 32(5): 442-446.
13.	Wu X, Li SH, Lou LM, et al. The techniques of soft tissue release and true socket reconstruction in total hip arthroplasty for patients with severe developmental dysplasia of the hip. Int Orthop, 2012, 36(9): 1795-1801.
14.	Bartz RL, Nobel PC, Kadakia NR, et al. The effect of femoral component head size on posterior dislocation of the artificial hip joint. J Bone Joint Surg (Am), 2000, 82(9): 1300-1307.
15.	赵德伟, 刘宇鹏, 崔旭. 大龄中、高位先天性髋脱位全髋置换术方法探讨. 中国骨与关节损伤杂志, 2006, 21(5): 350-352.
16.	Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res, 1987, (218): 136-141.
17.	Willis-Owen CA, Nishiwaki T, Spriggins AJ. Sciatic palsy after total hip arthroplasty associated with vascular graft occlusion. Hip Int, 2011, 21(1): 118-121.
18.	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.

1. Gee MJ, Ajuied A, Shah Z, et al. Systematic review of total hip arthroplasty in patients under 30 years old. Hip Int, 2013. [Epub ahead of print].
2. Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1): 15-23.
3. Cameron HU, Botsford DJ, Park YS. Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty, 1996, 11(5): 582-587.
4. Noble PC, Kamaric E, Sugano N, et al. Three-dimentional shape of the dysplastic femur: implications for THR. Clin Orthop Relat Res, 2003, (417): 27-40.
5. Christie M, Brinson MF. Proximal/distal mismatch: type A and C femurs. Orthopedics, 2005, 28(9 Suppl): s1033-1036.
6. Bruce WJ, Rizkallall SM, Kwon YM, et al. A new technique of subtrochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. J Arthroplasty, 2000, 15(5): 617-626.
7. Dapuzzo MR, Sierra RJ. Acetabular considerations during total hip arthroplasty for hip dysplasia. Orthop Clin North Am, 2012, 43(3): 369-375.
8. Tsukada S, Wakui M. Bulk femoral head autograft without decortication in uncemented total hip arthroplasty: seven- to ten-year results. J Arthroplasty, 2012, 27(3): 437-444.
9. Rozkydal Z, Smid Z, Kristek J. Structural bone grafting in THR with cup for dysplastic hip. Acta Chir Orthop Traumatol Cech, 2000, 67(5): 298-306.
10. Somferd MP, Bolder SB, Gardeniers JW, et al. Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips. Clin Orthop Relat Res, 2008, 466(2): 359-365.
11. Linde F, Jermen J, Pilgaard S. Charnley arthroplasty in osteoarthritis secondary to congenital dislocation or subluxation of the hip. Clin Orthop Relat Res, 1988, (227): 164-171.
12. 康鹏德, 杨静, 沈彬, 等. CroweⅣ型髋关节发育不良全髋关节置换术前计算机辅助设计. 中华骨科杂志, 2012, 32(5): 442-446.
13. Wu X, Li SH, Lou LM, et al. The techniques of soft tissue release and true socket reconstruction in total hip arthroplasty for patients with severe developmental dysplasia of the hip. Int Orthop, 2012, 36(9): 1795-1801.
14. Bartz RL, Nobel PC, Kadakia NR, et al. The effect of femoral component head size on posterior dislocation of the artificial hip joint. J Bone Joint Surg (Am), 2000, 82(9): 1300-1307.
15. 赵德伟, 刘宇鹏, 崔旭. 大龄中、高位先天性髋脱位全髋置换术方法探讨. 中国骨与关节损伤杂志, 2006, 21(5): 350-352.
16. Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res, 1987, (218): 136-141.
17. Willis-Owen CA, Nishiwaki T, Spriggins AJ. Sciatic palsy after total hip arthroplasty associated with vascular graft occlusion. Hip Int, 2011, 21(1): 118-121.
18. 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.

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TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE IV CONGENITAL DYSPLASIA OF HIP WITH DISLOCATION IN ADULTS

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