The peculiarities of hip arthroplasty under the conditions of congenital hip dislocation in adul ts
The goal: to optimize the tactics of total hip replacement (THR) under the conditions of congenital hip dislocation in adults.
Methods: the results of THR in 11 patients (8 females, 3 males) with congenital hip dislocation Crowe IV type. The age of patients amounts from 15 to 57 years (37.4 years in average). 12 operations THR were performed. One patient underwent THR on both hips. An acetabular component was implanted on the place of true acetabulum in all cases. For 6 patients with more than 4 cm shortening of lower extremity THR was performed only after brining down of femoral head on the level of pure acetabulum using external fixator. In the case of bilateral hip dislocation THR procedure was performed on both sides with shortening osteotomies of proximal femurs that prevented biomechanical discrepancy of the lower extremities. Stem of endoprosthesis was selected according to the shape of intramedullar cavity of proximal femur in all cases.
The results of treatment were observed from 6 months to 10 years. Average score according to Harris scale increased by 38.3 points. Healing of postoperative wounds was by the first intention. The bone grafts rearranged and played the role of acetabulum dome. The complications were observed in 2 cases. One patient with the shortening of 4.5 cm underwent THR simultaneously with extremity elongation. A sciatic neuritis was observed after the operation. The function of extremity was restored after 6 months of conservative treatment. Another case was associated with purulent complication that caused operative wound revision without removal of endoprothesis.
Full Text:PDF (Українська)
Akhtiamov IF, Sokolovskiy ОА. Surgery of hip joint dysplasia. Каzan, Operational Print Center. 2008. 371 p
Oleynik АЕ, Loskutov АЕ. Roentgen-anatomical analysis of acetabulum when hip joint dysplasy from arthroplasty position. Orthoped. Traumatol. Arthropl. 2008;4:71–7.
Zahorodniy NV, Nuzhdin VI, Kagramanov SV, Chragian GА. Peculirities of acetabulum arthroplasty in patients with dysplastic coxarthrosis. Russian Traumatology and Orthopaedy. 2012;1(63):66–72.
Mazurenko АВ, Tikhilov RМ, Shubnikov II. Evaluation of the possibility of limb length renovation in patients with severe types of dysplasia of the hip joint when different types of surgical arthroplasty. Russian Traumatology abd Orthopaedy. 2010;3(57):16–20.
Gerasymenko SІ, Poluliakh МV, Gerasymenko АS, et al. Method of bone plastics of acetabular covering. Patent 88538 UA. 2014
Poluliakh МV, Gerasymenko SІ, Kostiuk АD, Poluliakh DМ. Method of hip joint arthroplasty when congenital hip joint dislocation. Patent 99380 UA. 2012.
Tankut VО, Philipenko VА, Tankut ОV. Peculiarities of hip joint arthroplasty when severe types of dysplastic coxarthrosis. Orthopaedy, Traumatology and Arthroplasty. 2007;4:37–40.
Shaposhnikov YG. Тraumatology and Orthopaedy. Guidance for Doctors. Vol. 3. Мoskow: Medicine. 1997,625 p.
Тikhilov RМ, Shubniakov II, Mazurenko АV, et al. Experimental grounding for using acetabulum component with undercovering when arthroplasty in patients with severe types of dysplasia. Russian Traumatology and Orthopaedy. 2013;4:42–51.
Perekhodov SN, Volodin YS, Ismailov HG, Zhiburt ЕB. Arthroplasty in Russia Кazan-Saint-Petersburg. 2008, pp.30–5.
Slobodskoy АB, Badak IS, Voronin IV, et al. Hip joint arthroplasty in severe cases. Тrauma. 2011;2(12):15–20.
Anderson MJ, Harris WH. Total hip arthroplasty with insertion of the acetabular component without cement in hips with total congenital dislocation or marked congenital dysplasia. J Bone Joint Surg. 1999;81:347–54.
Takao M, Ohzono K, Nishii T, Miki H, Nakamura N, Sugano N. Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with development dysplasia. J Bone Joint Surg. Am. 2011;93(6):548–55. doi: 10.2106/JBJS.I.01619.
Eskelinen A, Helenius I, Remes V, Ylinen P, Tallroth K, Paavilainen T. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone Joint Surg. Am. 2006;88–A(1):80–91.
Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg. Am. 1979;61-A:15–23.
Koulouvaris P, Stafylas K, Sculco T, Xenakis T. Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction. A new surgical technique. J Arthroplasty. 2008;23(7):992–8. doi: 10.1016/j.arth.2007.09.013.
Hartofilakidis G, Stamos K, Karachalios T. Treatment of high dislocation of the hip in adults with total hip arthroplasty. Operativetechniqueandlong-termclinical results. J Bone Joint Surg. Am. 1998;80-A(4):510–17.
Paavilainen T, Hoikka V, Solonen KA. Cementless total replacement for severely dysplastic or dislocated hips. J Bone Joint Surg. Br. 1990;72-B(2):205–11.
The Norwegian Arthroplasty Register [web source]. 2010. 214 p. Access mode: http://nrlweb.ihelse.net/eng/ Report 2010.
Oinuma K, Tamaki T, Miura Y, Kaneyama R, Shiratsuchi H. Total hip arthroplasty with subtrochanteric shortening osteotomy for crowe grade 4 dysplasia using the direct anterior approach. J Arthroplasty. 2013;29(3):626–9. doi: 10.1016/j.arth.2013.07.038.
Vukasinović Z, Spasovski D, Zivković Z, et al. Triple pelvic osteotomy in the treatment of hip dysplasia. Srp. Arh. Celok. Lek. 2009;137(5/6):239–48.
Copyright (c) 2016 Mykhaylo Poluliakh, Sergey Gerasymenko, Dmitry Poluliakh
This work is licensed under a Creative Commons Attribution 4.0 International License.