Capsular arthroplasty for neglected developmental dysplasia of hip. (5th June 2018)

• Record Type: Journal Article
• Authors: Ahmad, Saeed; Qadir, Irfan; Zaman, Atiq uz; Khan, Chiragh Muhammad; Javed, Shahzad; Ahmad, Naeem; Aziz, Amer
• Is Part Of: Journal of orthopaedic surgery. Volume 26:Number 2(2018)
• Publication Date: 2018-06-05
• Subjects: 10 years -- adolescent -- capsular arthroplasty -- hip preservation -- neglected developmental dysplasia of hip -- Pakistan; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/2309499018777888
• Languages: English
• ISSNs: 1022-5536

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.