Clinical efficacy and prognostic analysis of autologous femoral head structural bone grafting combined with total hip arthroplasty for Crowe Type II/III developmental dysplasia of the hip in adults.

Objective: To evaluate the clinical efficacy and mid-term outcomes of total hip arthroplasty (THA) assisted by acetabular reconstruction using autologous femoral head structural bone grafting in patients with Crowe type II/III developmental dysplasia of the hip (DDH).

Methods: A retrospective analysis was conducted on 100 patients (100 hips) with Crowe type II/III DDH who underwent THA at the Affiliated Hospital of Xuzhou Medical University between January 2019 and December 2022. All patients received autologous femoral head structural bone grafting for acetabular reconstruction during the procedure. Perioperative parameters, visual analogue scale (VAS) scores, limb length discrepancy (LLD), range of motion (ROM), hip function [Harris hip score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)], incidence of complications, quality of life [Generic Quality of Life Inventory-74 (GQOLI-74)], and radiographic outcomes were assessed.

Results: The mean follow-up duration was 10.78 ± 1.65 months. Postoperatively, the VAS score significantly decreased from 6.52 ± 2.58 to 1.73 ± 0.72 (P < 0.001), and the LLD reduced from 2.88 ± 0.54 cm to 0.92 ± 0.39 cm (P < 0.001). The Harris hip score increased from 58.23 ± 6.14 to 92.45 ± 5.82 (P < 0.001), while the WOMAC score decreased from 72.54 ± 8.61 to 18.34 ± 5.09 (P < 0.001). All domains of the GQOLI-74 score showed significant improvements (P < 0.001). The overall complication rate was 1.0%, and radiographic assessments confirmed bone healing.

Conclusion: THA assisted by autologous femoral head structural bone grafting is a safe and effective approach for treating Crowe type II/III DDH. It significantly enhances hip function, restores biomechanics, improves the quality of life, and is associated with a low complication rate and favorable mid-term outcomes.