Efficacy of total hip arthroplasty in the treatment of Crowe Ⅱ and Ⅲ developmental dysplasia of hip in adults

doi:10.3877/cma.j.issn.1674-6880.2017.01.007

Abstract

Abstract:

Objective

To investigate the short-term efficacy of total hip arthroplasty (THA) in the treatment of CroweⅡand Ⅲ developmental dysplasia of hip (DDH) in adults after displacing the hip center of rotation on inner and upper side.

Methods

Forty-eight DDH patients (58 hips) with THA treatment in Taizhou Central Hospital from April 2006 to July 2014 were enrolled and divided into the three groups based on Crowe types. The research groups including the CroweⅡgroup [n = 14 cases (19 hips)] and the Crowe Ⅲ group [n = 11 (14 hips)], were treated with the technique of displacing the hip center of rotation on inner and upper side during THA. The control group was the CroweⅠgroup [n = 23 (25 hips)], and was treated with the technique of anatomical reconstruction of acetabulum. The X-ray films on post-anterior position were rechecked on 3 days, 3 months, 6 months and 24 months after THA surgery. We evaluated the post-operation function with imaging examination and Harris score.

Results

The comparison of the mean vertical distance [(18.3 ± 2.5) mm, (25.4 ± 3.2) mm, (29.6 ± 4.8) mm] and horizontal distance [(27 ± 5) mm, (21 ± 4) mm, (21 ± 4) mm] between rotation center and inter-teardrop line in the CroweⅠ, Ⅱ and Ⅲ groups after surgery were significantly different (F = 10.992, 11.271; all P < 0.05). There were no statistical differences of CE angles in the CroweⅠ, Ⅱ, Ⅲ groups [(16° ± 4°), (17° ± 4°), (16°± 5°); F = 0.355, P > 0.05]. The mean Harris scores between CroweⅠgroups and CroweⅡ, Ⅲ groups before surgery were significantly different [(51 ± 15) vs. (43 ± 17), (51 ± 15) vs. (39 ± 16); all P < 0.05]. On 3 months [(88 ± 10), (86 ± 12), (86 ± 13)], 6 months [(89 ± 9), (88 ± 10), (85 ± 13)] and 24 months [(88 ± 9), (88 ± 10), (86 ± 10)] after surgery, the mean Harris scores among the three groups have no significant differences (all P > 0.05). All patients had excellent gait without lamp and with negative Trendelanburg syndrome at the end of follow-up period.

Conclusions

The technology of acetabular reconstruction which displaces the hip center of rotation on inner and upper side can be an effective method in treating CroweⅡ and Ⅲ DDH. The short-term clinical efficacy and radiographic results achieved by this method are satisfied.

Key words: Developmental dysplasia of the hip, Total hip arthroplasty, Crowe type

Xianping Zhu, Xiao Teng, Chenshuai Pan, Hubing Wang, Yong Wang. Efficacy of total hip arthroplasty in the treatment of Crowe Ⅱ and Ⅲ developmental dysplasia of hip in adults[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2017, 10(01): 34-39.

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References 26

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组别	例数	男/女（例）	年龄（岁）	体质量（kg）	身高（cm）	BMI（kg/m²）
CroweⅠ型组	23（25髋）	3/22	54 ± 6	62 ± 8	164 ± 6	23.4 ± 1.9
CroweⅡ型组	14（19髋）	3/16	52 ± 7	63 ± 9	165 ± 7	22.1 ± 2.1
CroweⅢ型组	11（14髋）	1/13	55 ± 4	61 ± 6	163 ± 5	22.3 ± 2.2
F/χ²值	?	0.568	1.383	2.100	1.168	1.426
P值	?	0.753	0.270	0.144	0.326	0.192

组别	例数	男/女（例）	年龄（岁）	体质量（kg）	身高（cm）	BMI（kg/m²）
CroweⅠ型组	23（25髋）	3/22	54 ± 6	62 ± 8	164 ± 6	23.4 ± 1.9
CroweⅡ型组	14（19髋）	3/16	52 ± 7	63 ± 9	165 ± 7	22.1 ± 2.1
CroweⅢ型组	11（14髋）	1/13	55 ± 4	61 ± 6	163 ± 5	22.3 ± 2.2
F/χ²值	?	0.568	1.383	2.100	1.168	1.426
P值	?	0.753	0.270	0.144	0.326	0.192

组别	例数	旋转中心距离泪滴连线垂直距离（mm）	旋转中心距离泪滴垂线水平距离（mm）	CE角（°）
CroweⅠ型组	23（25髋）	18.3 ± 2.5	27 ± 5	16 ± 4
CroweⅡ型组	14（19髋）	25.4 ± 3.2^a	21 ± 4^a	17 ± 4
CroweⅢ型组	11（14髋）	29.6 ± 4.8^a	21 ± 4^a	16 ± 5
F值	?	10.992	11.271	0.355
P值	?	< 0.001	< 0.001	0.705

组别	例数	旋转中心距离泪滴连线垂直距离（mm）	旋转中心距离泪滴垂线水平距离（mm）	CE角（°）
CroweⅠ型组	23（25髋）	18.3 ± 2.5	27 ± 5	16 ± 4
CroweⅡ型组	14（19髋）	25.4 ± 3.2^a	21 ± 4^a	17 ± 4
CroweⅢ型组	11（14髋）	29.6 ± 4.8^a	21 ± 4^a	16 ± 5
F值	?	10.992	11.271	0.355
P值	?	< 0.001	< 0.001	0.705

组别	例数	术前	术后3个月	术后6个月	术后24个月
CroweⅠ型组	23（25髋）	51 ± 15	88 ± 10^a	89 ± 9^a	88 ± 9^a
CroweⅡ型组	14（19髋）	43 ± 17^b	86 ± 12^a	88 ± 10^a	88 ± 10^a
CroweⅢ型组	11（14髋）	39 ± 16^b	86 ± 13^a	85 ± 13^a	86 ± 10^a
F值	?	5.246
P值	?	0.035

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