Kısaltmalı Kalça Artroplastisi Yapılan Gelişimsel Kalça Displazili Hastaların Uzun Dönem Sonuçlarının Değerlendirilmesi
Özet
Developmental hip dysplasia (DDH) is an important disease that causes hip pain
and secondary osteoarthritis in adults if not treated appropriately in childhood.
Especially the treatment of patients with high hip dislocation poses difficulties in
adulthood. In this study, we aimed to compare the pre-operative and post-operative
clinical and radiological results and examine variables that may affect this results of
patients who were diagnosed with Crowe 4 high hip dislocation and underwent total
hip arthroplasty (THA) with subtrochanteric femoral shortening osteotomy (SFSO) in
the Department of Orthopedics and Traumatology, Hacettepe University Faculty of
Medicine. 77 hips of 62 patients who underwent THA with SFSO with the diagnosis
of DDH sequelae between 1995 and 2018 were included in our study. Demographic
and clinical findings, surgical complications, Harris hip score (HHS) and forgotten
joint scores (FJS) of the patients were evaluated retrospectively. Radiologically, pelvis,
hip and extremity length x-rays of the patients taken in the pre-operative and post-
operative periods were examined. With these radiographs, the staging of the patients,
rotation center change and limb length difference were calculated. Complications
during the follow-up period were noted. Statistical analysis of the obtained data was
performed using IBM® SPSS version 25 software. The mean age at surgery was
45.39±9.96 years, and the median follow-up period was 190.6 months (60.2-297.5
months). The difference between the preoperative and postoperative disruption levels
was found to be significant, with the patients' preoperative HHS increasing from 32.55
(25.3-73.8) to 94 (70.55-99.85) at the last follow-up. (p<0.001) The median FJS was
found to be 91.66 (58.3-100) at the last follow-up and a strong positive correlation was
observed between FJS and final follow-up HHS. (r=0.632, p<0.001) The overall
survival rate was %86.4 (%95 CI: 69.4-103.4). In our study, THA surgery with oblique
SFSO was performed using proximal 1/3 hydroxyapatite-coated stems and plate
fixation, was evaluated as a successful surgery with high survival that greatly increased
the clinical and functional scores of the patients.
