Hip Arthroplasty in Highly Dislocated Hips

Developmental disorder of the hip (DDH) is the most frequent disease of this joint. It is manifested by dysplasia, subluxation or luxation in childhood period and arthrosis in adults. Early degenerative changes of the hip occur at the location of disordered anatomy and biomechanics already in youth, while in the childhood age they are mostly asymptomatic (Ando & Gotoh, 1990). DDH mostly occurs in females, even 4-10 times more often than in males. Also, the disease is unevenly expanded, both ethnically and geographically, but also according to different habits in regard to the nursing care of neonates and infants. For example, the disease does not develop among the Bantu colored population, while in Canadian Indians it is very frequent rating even 12.3%, which is related to their habit of nursing babies in narrow wooden cradles. In those Indians who do not practice it the frequency is considerably lower (1.2%) (Vukasinovic et al., 1994, 2004). In our regions data on the frequency of DDH vary between 0.5-34.8%, depending on the regional customs in nursing children, but also on the method applied in the diagnostics of the disease; clinically it is the lowest, radiographically higher, and ultrasonographically the highest (Klisic et al., 1984). Former classical term of the disease was “congenital dislocation of the hip”, which, over the years became unsustainable, since it has been disclosed that the disease is not congenital, but that it often develops after birth under the influence of environmental factors. In addition, it does not always involve a total dislocation, but only disturbed interrelationship among the joint surfaces of the hip. Although the former term can be still found in the literature, today the term “developmental disorder of the hip” is accepted worldwide (Klisic, 1989).