Cementless total hip replacement without femoral osteotomy in patients with severe developmental dysplasia of the hip

Minimum 15-year clinical and radiological results

A. M. Imbuldeniya*, W. L. Walter, B. A. Zicat, W. K. Walter

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

We describe the clinical and radiological results of cementless primary total hip replacement (THR) in 25 patients (18 women and seven men; 30 THRs) with severe developmental dysplasia of the hip (DDH). Their mean age at surgery was 47 years (23 to 89). In all, 21 hips had Crowe type III dysplasia and nine had Crowe type IV. Cementless acetabular components with standard polyethylene liners were introduced as close to the level of the true acetabulum as possible. The modular cementless S-ROM femoral component was used with a low resection of the femoral neck. A total of 21 patients (25 THRs) were available for review at a mean follow-up of 18.7 years (15.8 to 21.8). The mean modified Harris hip score improved from 46 points preoperatively to 90 at final follow up (p < 0.001). A total of 15 patients (17 THRs; 57%) underwent revision of the acetabular component at a mean of 14.6 years (7 to 20.8), all for osteolysis. Two patients (two THRs) had symptomatic loosening. No patient underwent femoral revision. Survival with revision of either component for any indication was 81% at 15 years (95% CI 60.1 to 92.3), with 21 patients at risk. This technique may reduce the need for femoral osteotomy in severe DDH, while providing a good long-term functional result.

Original languageEnglish
Pages (from-to)1449-1454
Number of pages6
JournalBone and Joint Journal
Volume96B
Issue number11
DOIs
Publication statusPublished - 1 Nov 2014
Externally publishedYes

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