Capsular arthroplasty for neglected developmental dysplasia of hip.

Abstract

INTRODUCTION:

Treatment of developmental dysplasia of hip (DDH) diagnosed after 10 years of age is extremely difficult because of the soft tissue and bone deformities. In this study, we evaluated short-term results of a single-stage procedure performed with surgical hip dislocation, femoral shortening and capsular arthroplasty.

PATIENTS AND METHODS:

A retrospective review of charts of five patients with DDH, older than 10 years, who underwent capsular arthroplasty at Ghurki Trust Teaching Hospital between 2013 and 2015 was performed. Post-operative functional evaluation was performed using modified McKay's scoring system and radiographic assessment using Severin's scoring method at a minimum of 2-year follow-up.

RESULTS:

We present results of five patients (six hips) with a mean age of 18.16 years. All patients had limping gait and International Hip dysplasia Institute classification (IHDI) class 4 hip dislocation. Harris hip score showed a significant improvement (53.13 vs 84.16; p = 0.0001). Femoral shortening of 2-2.5 cm was done. Additional shelf procedure was required in one patient. This patient persistently has post-operative hip subluxation. All patients had good to excellent outcomes according to McKay classification. Post-operative Severin classification was 1A in all patients. No case of avascular necrosis of the femoral head was noted during the follow-up.

CONCLUSION:

Capsular arthroplasty with subtrochanteric shortening is a useful procedure for neglected cases of DDH in patients older than 10 years.

• Authors: Saeed Ahmad, Irfan Qadir, Atiq Uz Zaman, Chiragh Muhammad Khan, Shahzad Javed, Naeem Ahmad, Amer Aziz
• Journal: Journal of orthopaedic surgery (Hong Kong) (J Orthop Surg (Hong Kong)) 2018 May-Aug Vol. 26 Issue 2 Pg. 2309499018777888 ISSN: 2309-4990 [Electronic] England
• PMID: 29871541 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Arthroplasty (methods)
• Female
• Femur (surgery)
• Gait
• Hip Dislocation, Congenital (surgery)
• Humans
• Joint Capsule (surgery)
• Male
• Osteotomy
• Retrospective Studies
• Treatment Outcome
• Young Adult