Intermediate-term results after uncemented total hip arthroplasty for the treatment of developmental dysplasia of the hip

Objectives: We;ion to evaluate the restoration of the hip and limb length in patients with osteoarthrnis secondary to developmental dysplasia of the hip (DDH) using total hip arthroplasty (THA) Patients and methods: Between February 1996 and September 2001 65 hips in 55 patients (2 males. 53 females. mean age 48 6 years. ranee 37 to 60 years) with advanced osteoarthritis is secondary to DDH underwent uncemented THA According to the Hartofilakidis classification. 20.27. and 18 hips were evaluated types I (dysplasia), II (subluxation). and III (dislocation). respectively All of the acetabular cups were reconstructed in the original anatomic location Structural autografts were Used in seven hips to supplement the acetabular coverage We evaluated all patients clinically and radiographically Results: All of the patients were followed Up for 7-12 years. Preoperatively, the Harris score averaged 52 5, 48 41. and 45 28 in types 1 to 111, respectively At the final follow-up. the Harris score averaged 89.65, 8744, and 83 28. respectively The difference between the pre- and postoperative scores was significant (p=0 0001) Preoperatively. 26 patients (47 27%) had slight limps (length difference <1 cm). eight (14 55%) had moderate limps (length difference 1-3 cm). and 21 (38 18%) had severe limps (length difference >3 cm) At then final follow-up. four (7 27%) had severe limps The limps of all of the patients improved significantly (McNemar s test p=0 0001) We observed aseptic loosening and subsidence in six hips In seven hips. we used a femoral head autograft for the superior acetabular defect We performed femoral shortening osteotomies only tor two (3 07%) type III hips Conclusion: In addition to the standard procedure. structural bone autografting, medialization of the cup, and placing the acetabular component in the true acetabulum ale important factors for successful intermediate-term results