Chapters authored
Total Hip Replacement in Developmental Dysplasia
Total hip arthroplasty (THA) for osteoarthritis secondary to development dysplasia of the hip (DDH) is facing increasing levels of complexity with increasing grade of deformity. The dysplastic acetabulum is characterized by diminished bone stock with decreased lateral coverage. Therefore, it is challenging to restore the anatomic center of rotation and ensure adequate acetabular component fixation. Surgical strategies include a medialization of the acetabular component, a higher hip center, lateral structural bone grafting and the selection of smaller component sizes to improve native bone coverage. Excessive femoral anteversion is commonly encountered in patients with developmental dysplasia. Moreover, the intramedullary canal is narrow and the neck often aligned in valgus. Modular implants are helpful to address the altered femoral anatomy and also facilitate femoral shortening osteotomies in patients with high hip dislocation. Although clinical results are comparable to primary total hip replacement in primary osteoarthritis, the risk for revision surgery due to dislocation and loosening is increased. The current chapter reviews classification, preoperative planning, and surgical strategies for patients undergoing THA for osteoarthritis secondary to developmental dysplasia.
Part of the book: Developmental Diseases of the Hip