[Cementless total hip arthroplasty for developmental dislocation of the hip in adults].

OBJECTIVE

To evaluate the operative technique and the short-term clinical effect of cementless total hip arthroplasty (THA) for developmental dislocation of the hip in adults.

METHODS

From December 1997 to October 2006, 61 patients (78 hips) with developmental dislocation of the hip were treated with the cementless THA. There were 8 males and 53 females with the average age of 31.4 years (ranging from 17 years to 56 years). According to the classification of Hartofilakidis, 15 cases were type I (18 hips), 23 type II (31hips), and 23 type III (29 hips). All the patients were exposed through the posterolateral approach. The threaded cup with coating was put at or near the level of the true acetabulum in all cases. Full coating stems were used in femoral sides, and shortening osteotomy below trochanter of femur was performed in 12 cases.

RESULTS

Sixty patients (76 hips) were followed up with the mean duration of 49 months (range 12 to 118 months). All the hips of osteotomy and bone ingrowth acquired union 3 to 14 months after the operation. No patient had radiographic evidence of aseptic loosening of prosthesis. The average leg length of the hips with femoral shortening osteotomy was lengthened 2.0 to 4.5 cm. All patients had pain relief and no obvious motion limitation, limp gait and pelvic obliquity. The Harris scores were 40.28 +/- 9.84 preoperatively and 90.92 +/- 2.80 postoperatively (P < 0.001). One patient with postoperative femoral nerve palsy completely recovered 4 months after the operation.

CONCLUSION

Cementless THA for developmental dislocation of the hip in adults produces significantly better results, although it presents great technical difficulties.