Total Hip Arthroplasty Performedi Secondary Hip Osteoarthritis Caused by Hartofilakidis Type 2 and Type 3 Developmental Dysplasia of the Hip; Evaluation of Outcomes and Comparison of Clinical Scores of These Two Types

Abstract

The aim of this study was to evaluate the outcomes of Total hip arthroplasty (THA) performed for hip osteoarthritis caused by Hartofilakidis type 2 and 3 developmental dysplasia of the hip (DDH) and to compare these two types in terms of clinical scores. Thirty-six hips of thirty patients who suffered from hip osteoarthritis caused by DDH and who underwent THA operations from January 2005 to May 2010 were included in the study. In the case of insufficient coverage of the acetabular cup, roof reconstruction was performed using femoral head autografts. Subtrochanteric transverse femoral osteotomy was performed when required. Clinical evaluations were performed using Harris Hip Score (HHS). 3 male and 27 female patients were included in this study. Mean age was 57.2 (25-76) years. Mean follow up time was 34.3 (12–65) months. 24 hips were classified as Hartofiladikis type 2, and 12 as type 3. HHS was 43.2 (38-54) points and 90.1 (76-96) points at the preoperative and postoperative last control visits, respectively (p<0.001). Hartofilakidis type 2 hips scored 42.5(38-46) points and 89.9(78-96) points at preoperative and postoperative last control visits, respectively. Hartofilakidis type 3 hips scored 44.7 (38-54) points and 90.4 (76-96) points at preoperative and postoperative last control visits, respectively. There was no difference between the type 2 and type 3 in terms of clinical outcomes (p=0.23, p=0.81). If a proper acetabular reconstruction can be performed by taking into account the restoration of abductor force and the acetabular coverage also by considering acetabular cup position, and if a proper femoral reconstruction can be performed when required via the use of subtrochanteric transverse osteotomy and by considering anatomical changes, successful and similar clinical outcomes can be achieved in hip osteoarthritis secondary to Hartofilakidis type 2 or type 3 DDH.