Total hip arthroplasty in skeletal dysplasias: patient selection, preoperative planning, and operative techniques

• Published in: The Journal of arthroplasty Vol. 19; no. 1; pp. 1 - 7
• Main Authors: Ain, Michael C, Andres, Brett M, Somel, Deniz S, Fishkin, Zair, Frassica, Frank J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2004
• Subjects: Adult; Arthroplasty, Replacement, Hip - methods; Bone Diseases, Developmental - complications; Bone Diseases, Developmental - surgery; customized prosthesis; Female; Hip Joint - physiopathology; Humans; Male; Osteoarthritis, Hip - complications; Osteoarthritis, Hip - physiopathology; Osteoarthritis, Hip - surgery; Patient Selection; Postoperative Care; preoperative planning; Prosthesis Design; Range of Motion, Articular; skeletal dysplasia; total hip arthroplasty; total hip arthroplasty; patient selection; preoperative planning; customized prosthesis; skeletal dysplasia
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/S0883-5403(03)00455-8

Patients with substantial skeletal dysplasia and hip arthritis are poor candidates for noncustom total hip arthroplasty (THA) because of hip size and deformity. To determine the efficacy of THA via modified prostheses and surgical techniques in this population, the authors analyzed 9 consecutive THAs in 7 small-stature adults (mean height, 118.6 cm; mean weight, 47.5 kg). The Student
t-test was used to test for significant (
P < 0.05) differences in outcome variables. Seven hips received custom femoral components based on imaging studies. Five hips required extensive soft-tissue releases secondary to severe contractures. Follow-up radiographs (range, 24–56 months) showed adequate position of all prostheses and no loosening. Follow-up mean pain and function scores (Harris Hip Score and WOMAC Arthritis Index) showed significant improvement from preoperative levels.