We reviewed 18 total hip replacement arthroplasties for osteoarthrosis secondary to congenital hip dislocation and hip dysplasia. All arthroplasties were performed by the first author at our department from January 1976 to December
1992.
All but two patient(3 hips) were female. The mean age of the patients at operation was 34 years (19 to 56). The mean leg length descrepancy was 4.2cm(1 to 7cm).Crowe grade of subluxation were graed I in 1 hip, grade II in 7 hips, grade III
in
5
hips and graed IV in 5 hips. Acetabular wall reconstruction with bone graft was performed in 10 hips. The prosthesis used were Ominfit(Osteonics, U.S.A.) in 6 hips, PM type(aesculap, Germany) in 4 hips, Muller type(Zimmer, U.S.A.) in 1 hip.
Preoperative traction and femoral shortening was done in 1 hip. Secondary operation and femoral shortening was done in 1 hip. Secondary operation was necessary after 2 weeks traction due to failed reduction. The mean followed up
period
was 7 years and 11 months(1 year and 4 months to 18 years and 7 months). the mean Harris score was improved from 40 preoperatively to 85 postoperatively. Endividual scores were beforesurgery: pain, 15(0 to 30); activity, 16(12
to
24);function, 8(6 to 10). At the time of review, the scores were: pain, 42(30 to 45); activety, 28(15 to 30); function, 12(10 to 14). On the femoral side, all showed no loosening and stable bony fixation was noted in cementless cases. Cups
loosening were found in six hips and revision was performed in one hip of them. Two peroneal nerve palsies were occured: one after operation; another one during traction.
At 7 years and 11 months of follow-up, clinically and radiologically satisfactory results were obatined in our study. However, cup loosening was noted in all cemented cup fixation cases which were performed before 1980. In cementless
cup
fixation cases even before the age of 45, no cup loosening was found. Survival analysis with Kaplan-Meier showed the good results in cases using cementless and modern desinged prosthesis. Long term follow-up is mandartoy for the precise
evaluation and anlysis of survival of hip arthroplasty.
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