Total hip arthroplasty in developmental dysplasia of the hip patients: Mid-term results

Abstract

Background: Developmental dysplasia of the hip (DDH) leads to secondary osteoarthritis (OA) in adolescents and young adults. The abnormal bone morphology makes total hip arthroplasty (THA) in these patients challenging with high complication rates. This study aims to report the radiological and functional outcomes of THA in DDH patients in the South Indian population. Methodology: All DDH patients who underwent THA for secondary OA of the hip in our hospital between 2008 and 2021 were included in the study. Functional outcomes were measured using preoperative and postoperative Oxford hip score (OHS) and short form-12 (SF12) form. Radiological imaging was used to assess Crowe's classification, radiolucency, acetabular inclination angle, and offsets. Results: Mean follow-up duration was 5.5 years (2–12 years). A total of 16 DDH patients were included in the study. OHS and SF-12 scores remarkably improved compared to preoperative scores. Bony ingrowth with no evidence of loosening was seen consistently on both femoral and acetabular side in all patients on X-rays. Our complications included one posterior dislocation, one acetabular screw cutout in the immediate postoperative period, and one patient with subtrochanteric nonunion at the osteotomy site. Conclusions: THA in arthritic dysplastic hips had consistent improvement in the hip scores and quality of life. The use of the excised shortened vascularized graft technique described below-hastened osteotomy healing to 6 weeks as compared to the earlier technique. Deferring immediate partial weight-bearing in Crowe IV hip may minimize the risk of cup failure and screw cutoff.