Results of our surgical therapy of total hip arhroplasty at the patients with coxarthrosis following the devolopmental dislocation of the hip

Clinical and radiological evaluations were made for 90 hip of 70 patients enrolled in the study. 10 patients were men and 60 patients were women and the average age of operation was 46.73 (23-74). 18 patients had right total hip arthroplasty, 32 had left and 20 had bilateral total hip arthroplasty. Average follow-up period was 52.12 months. In the radiological aspect, according to Crowe classification, 30 of 90 hip were of Type 1, 9 of Type 2, 10 of Type 3 and 41 were of Type 4. Plain radiographs were assessed according to the radiological follow- up parameters of Callaghan. 88 of 90 hip were placed in the true acetabulum. Subtrochanteric femoral shortening osteotomy was applied for 25 hip. It was observed that otografts taken from femoral head were placed in the superolateral portion of acetabulum in 9 hip of which the acetabular components lack more than %30 of their support. It was seen that for the acetabular component, expansion cup was used in the first cases than mostly the acetabular cup with screws have been used. All prostheses were applied without using any cement. Harris Hip Evaluation Form was used for the clinical evaluation of patients. The pain scores were assessed by Harris Pain Scoring and Visual Analogous Scale (VAS). While the preoperative average Harris and VAS scores were 32,5 and 9,14 respectively, the postoperative scores were detected as 86,5 and 1,42. According to Harris Scoring, in the last follow-up visits, 64 of cases were evaluated as excellent, 12 as very favouarble, 8 as favourable, 5 as moderate and 1 as bad result. The complications were as follows: temporary femoral nerve paralysis in 1 hip and sciatic nerve paralysis in 2 hip, femoral fissure or fracture during component insertion in 16 hip, dislocation in 7 hip, aseptic relaxation in 7 hip, infection in 1 hip, deep vein trombosis in 1 patient, pulmonary embolism in 1 patient. When compared with literature data, the postoperative clinical and radiological results of total hip artroplasties that we performed without cement application in coxarthrosis cases secondary to developmental dysplasia of hip are promising.