O3164 UNCEMENTED TOTAL HIP ARTHROPLASTY IN THE TREATMENT OF DYSPLASTIC COXARTHROSIS

Abstract

Aims: The purpose of this study was to evaluate the late results after total hip arthroplasty in young patients with dysplastic coxarthrosis. Methods: In our Institution between the years 1985 Ð 2001, 949 total hip arthroplasties (THA) were performed because of severe hip arthrosis. From this group, 186 patients (231 hips) were diagnosed as dysplastic coxarthrosis and this group (176 female and 10 male) was selected for further evaluations. The average age at the time of surgery was 38,1 years (from 18 to 52 years). In the early childhood 141 patients (75,8%) were surgically treated because of hips dysplasia, non-surgical treatment was applied in 33 patients (17,7%) and no treatment at all in 12 cases. The uncemented THA was performed in 208 hips (90%) before the age of 50 years. We used the Crowe classiþcation to group dysplastic hips before the surgery. To the Crowe class 1 were classiþed 57 hips (24,7%), to class 2 Ð 78 hips (33,8%), class 3 included 69 hips (29,9%) and class 4 Ð 27 hips (11,6%). The clinical outcome was rated according to the Harris hip-scoring system. Radiological appearance based on de Lee and Gruen classiþcation and overall placement of prosthesis. Results: In our material we noted excellent results in 103 hips, good in 64, fair in 45 and poor results in 19 hips. Poor results were mostly connected to aseptic loosening of the prosthesis. The clinical results were slightly better than radiological. Conclusions: Treatment of dysplastic coxarthrosis is difþcult and connected with high rate of complication and technical problems during the surgery. The most common complications occurred in hips class 3 and 4 according to Crowe classiþcation. In 8% of all treated hips, revision THA was necessary because of different type of complications.