Bektaşer Bülent, Solak Sükrü, Oğuz Temel, Oçgüder Ali, Akkurt Mehmet Orçun
Department of Orthopedics and Traumatology (2. Ortopedi ve Travmatoloji Kliniği), Atatürk Training and Research Hospital, Ankara, Turkey.
Acta Orthop Traumatol Turc. 2007;41(2):108-12.
We evaluated eight-year results of total hip arthroplasty in patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH).
Total hip arthroplasty was performed in 31 hips of 29 patients (25 females, 4 males; mean age 54 years; range 35 to 78 years) with osteoarthritis secondary to DDH. According to the classification by Hartofilakidis et al., there were 13 type 1 hips, 13 type 2 hips, and five type 3 hips. The acetabular component was placed in the true acetabulum in all the hips. Hybrid and uncemented prostheses were used in six hips and 25 hips, respectively. Eight patients with severe acetabular deficiency required augmentation with an autogenous bone graft. Soft-tissue releases were performed in seven hips. Femoral shortening osteotomy was performed for high hip dislocations. All the patients were evaluated using the Merle d'Aubigne and Harris hip scores. The mean follow-up period was eight years (range 1 to 10 years).
According to the postoperative Merle d'Aubigne and Harris hip scores, the results were excellent in eight hips (25.8%), good in 17 hips (54.8%), fair in five hips (16.1%), and poor in one hip (3.2%). The mean length discrepancy between the two extremities was 1.7 cm (range 0.5 to 2.5 cm). Complications included nonunion of the acetabular graft in one patient and superficial wound infection in two patients. Neurologic complications did not occur. Three patients required revision for loosening of the acetabular (n=2) or femoral (n=1) components.
Successful results can be obtained with good planning and proper surgical procedures in the treatment of osteoarthritis secondary to DDH.
我们评估了发育性髋关节发育不良（DDH）继发骨关节炎患者全髋关节置换术的八年结果。
对29例（25例女性，4例男性；平均年龄54岁；范围35至78岁）DDH继发骨关节炎患者的31个髋关节进行了全髋关节置换术。根据Hartofilakidis等人的分类，有13个1型髋关节、13个2型髋关节和5个3型髋关节。所有髋关节的髋臼组件均放置在真髋臼中。分别在6个髋关节和25个髋关节中使用了混合假体和非骨水泥假体。8例髋臼严重缺损患者需要自体骨移植进行增强。7个髋关节进行了软组织松解。对高位髋关节脱位进行了股骨缩短截骨术。所有患者均使用Merle d'Aubigne和Harris髋关节评分进行评估。平均随访期为八年（范围1至10年）。
根据术后Merle d'Aubigne和Harris髋关节评分，8个髋关节（25.8%）结果为优，17个髋关节（54.8%）为良，5个髋关节（16.1%）为中，1个髋关节（3.2%）为差。双下肢平均长度差异为1.7 cm（范围0.5至2.5 cm）。并发症包括1例患者髋臼移植骨不愈合和2例患者浅表伤口感染。未发生神经并发症。3例患者因髋臼（n = 2）或股骨（n = 1）组件松动需要翻修。
通过良好的规划和适当的手术操作，DDH继发骨关节炎的治疗可以取得成功的结果。
