Local experience with total hip replacement in dysplastic coxarthrosis.

Background. The goal of our study was to assess the efficacy of total hip replacement in the treatment of dysplastic arthrosis of the hip. Material and methods. Between November 2001 and June 2003 we performed total hip replacement in 40 patients (46 hips). Arthritic deformations were classified according to Crowe's classification scheme and operated using a variety of techniques and prostheses. Outpatient examinations were performed every 6 weeks. Rehabilitation began 24 hours after surgery. Results. The average time of hospitalization was 14 days. According to Harris's scale, the average result was 35.4 before operation, 59.8 immediately after surgery, and 79.16 at 18 months post-operatively. The average difference between lower limbs was 3 cm before surgery and 1 cm post-operatively. The average range of flexion in the hip preoperatively was 36 degrees , 85 degrees post-operatively. All the patients suffered pain in the dysplastic hip before surgery; 4.4% patients still felt pain 12 months after surgery. In 2 cases there was loosening of the acetabular component of the prosthesis, which required revision surgery. In 3 cases there was dislocation of prosthesis. In 2 cases the implant was infected. In 1 case there was paresis of the femoral nerve. Thromboembolism occurred in 3 cases. Conclusions. In Crowe's first and second degree dysplastic arthrosis of the hip, a good outcome is obtained with standard stem prosthesis. A CDH stem should be used in stenosis of the intramedullary canal. Patients with dysplastic hips have better quality of life after total hip replacement.