The results of total arthroplasty for developmental dysplasia of the hip
Keywords:hip dysplasia, arthroplasty, results
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.
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.
Copyright (c) 2021 TRAUMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.