The results of total arthroplasty for developmental dysplasia of the hip

Authors

  • A.I. Kanziuba SHEI “Uzhhorod National Medical University”, Uzhhorod, Ukraine
  • D.A. Yurchenko SRI TA Donetsk National University, Lyman, Ukraine

DOI:

https://doi.org/10.22141/1608-1706.6.21.2020.223881

Keywords:

hip dysplasia, arthroplasty, results

Abstract

Background. In developmental dysplasia of the hip joint in adults, total arthroplasty is recognized as a non-alternative surgical intervention. In scientific and practical aspects, the main task of arthroplasty is the maximum restoration of musculoskeletal function or compensation of biomechanical disorders, as well as providing conditions for the long-term preservation of the stability of the implant. The purpose of this work is to investigate the factors that determine the results of total arthroplasty for developmental hip dysplasia in the middle follow-up period. Materials and methods. There were examined 84 patients who underwent total hip arthroplasty for developmental hip dysplasia during 2014–2019. The timing for evaluating the results was chosen based on the observations that a certain stable level of the achieved result is formed in the period from 1 to 3 years, depending on the severity of the anatomical disorders. Results. A total of 116 total arthroplasty operations were performed. Of these, there were dysplasia Crowe type I in 52 (44.8 %) cases, type II — in 34 (29.4 %), type III — in 26 (22.4 %), type IV — in 4 (3.4 %) cases. The concept of the study was to study the factors that influence the choice of surgical tactics, especially after surgical rehabilitation treatment and functional results in the medium term. Generalized results on the W. Harris scale are as follows: excellent (average score 92.3) — 39 (46.4 %), good (average score 86.6) — in 26 (30.9 %), satisfactory (average score 78.3) — in 15 (17.9 %), unsatisfactory (average score 67.4) — in 4 (4.8 %). The condition of the bone and soft tissues of the hip as well as the degree of anatomical abnormalities are critical for the successful implementation of arthroplasty. After arthroplasty for II and III types of dysplasia, limping, leg length discrepancy, and a feeling of muscle weakness are observed. They are caused by such factors as asymmetric hip rotation, violation of the femoral offset, scoliotic deformity of the lumbar spine. Conclusions. After arthroplasty for hip dysplasia, patients need more prolonged rehabilitation treatment and the results of arthroplasty are determined by the degree of compensation of anatomical and functional disorders achieved.

References

Vasileios I.S., Michael C., Gregory S., George C.B. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement. Arch. Bone Joint Surg. 2014. № 2(3). P. 130-136. PMCID: PMC4225014.

Bicanic G., Barbaric K., Bohacek I., Aljinovic A., Delimar D. Current concept in dysplastic hip arthroplasty: Techniques for acetabular and femoral reconstruction. World J. Orthop. 2014 Sept 18. № 5(4). P. 412-424. DOI: 10.5312/wjo.v5.i4.412.

Karachalios T., Hartofilakidis G. Congenital hip disease in adults: terminology, classification, preoperative planning and management. J. Bone Joint Surg. Br. 2010. № 92(7). P. 914-21. DOI: 10.1302/0301-620X.92B7.2411

Clohisy J.C., Dobson M.A., Robison J.F. Radiographic structural abnormalities associated with premature, natural hip-joint failure. J. Bone Joint Surg. Am. 2011. Vol. 93. Suppl. 2. P. 3-9. DOI: 10.2106/JBJS.J.01734.

Xinyu Q., Ke J., Jinlun C. et al. Post-THA gait training to improve pelvic obliquity and decrease leg length discrepancy in DDH patients: a retrospective study. Journal of International Medical Research. 2020. № 48(3). P. 1-8. DOI: 10.1177/0300060519898034.

Olukemi L., Michael O., Imoniche A.-S., Charles A. Acetabular and femoral reconstruction in total hip replacement for adult hip dysplasia: A technical guide for surgeons in our environment. Nigerian Journal of Orthopaedics and Trauma. 2019. Vol. 18. Iss. 1. P. 1-3. DOI: 10.4103/njot.njot_1_19.

Xiao-tong S., Chao-feng L., Cheng-ming C., Chun-yang F., Shu-xuan L., Jian-guo L. Preoperative Planning for Total Hip Arthroplasty for Neglected Developmental Dysplasia of the Hip. Orthopaedic Surgery. 2019. Vol. 11. P. 348-355. DOI: 10.1111/os.12472.

Massimo M., Olimpio G., Giovan G.C., Recano Р., Simo­ne C. Quality of life and functionality after total hip arthroplasty: a long-term follow-up study. Musculoskeletal Disorders. 2011. 12. P. 222. DOI: 10.1186/1471-2474-12-222.

Crowe J.F., Mani V.J., Ranawat C.S. Total hip replacement in congenital dislocation and dysplasia of the hip. J. Bone Joint Surg. Am. 1979. № 61. P. 15-23. PMID: 365863.

Косинская Н.С. Дегенеративно-дистрофические поражения костно-суставного аппарата. Л.: Медгиз, 1961. 202 c.

Harris W.H. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J. Bone Joint Surg. Am. 1969. № 51(4). P. 737-755. PMID: 5783851.

Greber E.M., Pelt C.E., Gililland J.M., Anderson M.B., Erickson J.A., Peters C.L. Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip. J. Arthroplast. 2017. № 32(9S). P. 38-44. DOI: 10.1016/j.arth.2017.02.024.

Xu J., Xu C., Mao Y., Zhang J., Li H., Zhu Z. Posterosuperior placement of a standard-sized cup at the true acetabulum in acetabular reconstruction of developmental dysplasia of the hip with high dislocation. J. Arthroplast. 2016. № 31(6). P. 1233-1239. DOI: 10.1016/j.arth.2015.12.019.

Sakellariou V.I., Christodoulou M., Sasalos G., Babis G.C. Reconstruction of the acetabulum in developmental dysplasia of the hip in total hip replacement. Arch. Bone Joint Surg. 2014. № 2(3). P. 130-136. PMID: 25386570.

Heng Z., Jiansheng Z., Jianzhong G., Hai D., Zhiyan W., Qirong D. How to restore rotation center in total hip arthroplasty for developmental dysplasia of the hip by recognizing the pathomorphology of acetabulum and Harris fossa? Journal of Orthopaedic Surgery and Research. 2019. № 14. P. 339-347. DOI: 10.1186/s13018-019-1373-9.

Филиппенко В.А., Климовицкий Р.В., Тяжелов А.А., Карпинский М.Ю., Карпинская Е.Д., Гончарова Л.Д. Подбор компонентов эндопротеза и величина общего бедренного офсета после эндопротезирования тазобедренного сустава (рентгенометрическое исследование). Травма. 2018. Т. 19. № 1. С. 13-19. DOI: 10.22141/1608-1706.1.19.2018.126658.

Published

2021-04-05

Issue

Section

Original Researches