Chaudhry Faran, Bridger Adam, Daud Anser, Greenberg Arieh, Safir Oleg A, Gross Allan E, Kuzyk Paul R
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
J Arthroplasty. 2025 Aug;40(8S1):S236-S242. doi: 10.1016/j.arth.2025.03.070. Epub 2025 Apr 1.
Developmental dysplasia of the hip (DDH) is a major cause of hip arthritis in young adults. Total hip arthroplasty (THA) is an effective treatment for DDH, but few studies have examined mid- (5 to 10 years) to long-term (> 10 years) outcomes. This study reports the long-term survivorship, clinical, and radiographic outcomes of THA in DDH patients.
A total of 255 patients were included from our retrospective review of THAs from January 2004 to January 2022. Among these cases, 214 (83.9%) were women; the mean age at the time of surgery was 46 years (range, 18 to 87), and the mean follow-up was 8.3 (range, 0.05 to 21.1) years. Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery for any reason.
Kaplan-Meier survivorship for patients who underwent THA to treat DDH due to all-cause failure was 93.4% (95% confidence interval (CI): 90.3 to 96.5) at 5 years, 92.5% (95% CI: 89.0 to 95.6) at 10 years, and 90.9% (95% CI: 86.2 to 94.0) at 15 years. The overall rate of revision of the index surgery was 18 of 255 (7.1%). These complications included pain (seven), dislocation (four), aseptic loosening of the cup (three), periprosthetic fracture (two), complete foot drop (one), and infection (one). Kaplan-Meier all-cause survivorship for Hartofilakidis A, B, and C was also conducted and showed no significant differences. The mean femoral offset improved from a preoperative value of 12.2 cm (SD 1.4) to a postoperative value of 11.7 cm (SD 1.1) (P < 0.001). The rate of femoral nerve palsy was 0.78%.
Our study suggests THA for DDH is a viable treatment, providing excellent mid-term to long-term survivorship, clinical, and radiographic outcomes with a low complication rate. Future research should evaluate patient-reported outcomes and long-term follow-up in larger cohorts.
发育性髋关节发育不良（DDH）是年轻成年人髋关节炎的主要原因。全髋关节置换术（THA）是治疗DDH的有效方法，但很少有研究探讨中期（5至10年）至长期（>10年）的疗效。本研究报告了DDH患者THA的长期生存率、临床和影像学结果。
我们对2004年1月至2022年1月的THA进行回顾性研究，共纳入255例患者。其中，214例（83.9%）为女性；手术时的平均年龄为46岁（范围18至87岁），平均随访时间为8.3年（范围0.05至21.1年）。采用Kaplan-Meier生存分析，将因任何原因进行翻修手术定义为失败。
因各种原因失败而接受THA治疗DDH的患者，5年时Kaplan-Meier生存率为93.4%（95%置信区间（CI）：90.3至96.5），10年时为92.5%（95%CI：89.0至95.6），15年时为90.9%（95%CI：86.2至94.0）。初次手术的总体翻修率为255例中的18例（7.1%）。这些并发症包括疼痛（7例）、脱位（4例）、髋臼无菌性松动（3例）、假体周围骨折（2例）、完全性足下垂（1例）和感染（1例）。还对Hartofilakidis A、B和C型进行了Kaplan-Meier全因生存率分析，结果显示无显著差异。股骨偏心距平均值从术前的12.2 cm（标准差1.4）改善至术后的11.7 cm（标准差1.1）（P<0.001）。股神经麻痹发生率为0.78%。
我们的研究表明，THA治疗DDH是一种可行的治疗方法，可提供良好的中期至长期生存率、临床和影像学结果，并发症发生率低。未来的研究应评估患者报告的结局以及更大队列中的长期随访情况。
