در دو بيمارستان تهران طي سال هاي 1371-1380 DDH بررسي نتايج باليني و پرتونگاري تعويض كامل مفصل هيپ در بيماران

Short - Term Results of Total Hip Replacement in Developmental Dysplasia or Dislocation of Hip ( Results of Two to Ten Years )

Background: Total hip arthroplasty in patients with dysplastic hips following developmental hip dislocation (DDH) is a demanding procedure with high rate of complication. DDH is, relatively, a common illness in our country. The information on hip arthroplasty and its results in this country is limited. We are reporting a short-term outcome on a group of patients from two hospitals in Tehran who underwent such a procedure during a 10 year period (1992-2001). Method: This is a case series study of 53 total hip replacements in cases of hip dysplasia, which had at least, 2 years of follow-up. The preoperative Harris Hip Scores (HHS) and radiographic assessments were compared with post operative evaluations. The different additional procedures like femoral shortening, acetabular grafting, as well as the type of implants used for hip arthroplasty were assessed. The demographic parameters and their affects on final outcome were recorded. Results: 53 patients with age range of 27-70 with a mean follow-up of 3.9 years (2-10), obtained an improvement of HHS from 31 to that of 95. Improvement in limping was observed in 79% of cases. All cases were satisfied with the surgery, despite 18.5% complication rate (5 cases of transient nerve palsy and 4 cases of deep vein thrombosis). Conclusion: THR for DDH with the complexity of such hips is a difficult procedure which requires good preoperative planning and technical expertise. Femoral shortening can be useful to decrease the incidence of nerve injury and allow placement of the prosthesis into original acetabulum. The improvement in gait is the main reason for patientsʹ satisfaction observed in most cases.