Total Hip Replacement in Developmental Dysplasia of the Hip: Pitfalls and Challenges

Abstract

Introduction: Surgical treatment methods for developmental dysplasia of the hip (DDH) in the elderly patients contain pelvic or periacetabular osteotomy and hip arthroplasty. Total hip arthroplasty (THA) is the last and definitive surgical treatment modality for the end stage developmental dysplasia of the hip. Deformity classification and reconstruction:Crowe classification system describes the degree of dysplasia and gives information about the reconstruction procedure with hip arthroplasty. Classification is based on the magnitude of proximal femoral migration relative to the acetabulum. Acetabular component must be implanted to the true acetabulum for the optimal range of motion and stability of the reconstructed hip. The femoral component must be placed in neutral or slight anteversion but narrow femoral canal can be a problem for the reconstruction of femur. Conclusion-key results:The results of total hip arthroplasty in developmental dysplasia of the hip have been satisfactory for stability, mobility, and pain relief. The survivorship of cemented arthroplasty in dysplastic hips is inferior because of the young age of the patients and the complexity of the procedures. Early and midterm results of cementless hip arthroplasty are better. Most important complications after the surgery are dislocation of the reconstructed hip and sciatic nerve injury.