Sage Journals: Discover world-class research

Abstract

BACKGROUND:

The optimal rehabilitation program for patients with post-total hip arthroplasty (THA) after developmental dysplasia of the hip (DDH) remains unclear.

OBJECTIVE:

The aim of the present study was to evaluate the clinical outcomes, to define a postoperative rehabilitation program, and to report the complication rate of THA in patients with DDH.

METHODS:

DDH hips ( $n=$ 89) were recruited. The transverse proximal femoral shortening osteotomy was applied to all patients. The rehabilitation program was performed on the first day immediately after operation to the 6 ${}^{\text{th}}$ week. Pain was assessed via Visual Analogue Scale, and the function was evaluated by the Harris Hip Score at the end of the 3 ${}^{\text{rd}}$ month and the first year. The weakness of hip abduction was assessed via the Trendelenburg test before the operation and at one year.

RESULTS:

Statistically significant improvements were seen for pain ( $p<$ 0.001) and function ( $p<$ 0.001) in the third month. This improvement continued for pain from three months to one year ( $p<$ 0.001). However, the function did not increase from month three to one year ( $p=$ 0.47). The Trendelenburg test was positive in all cases in the first assessment; it decreased to 24.7% at one year. The complication rate was 11.23%.

CONCLUSIONS:

The pain and function of patients who performed exercise following THA due to DDH might improve, especially in the first three months.

Keywords

Pain function arthroplasty exercises rehabilitation hip developmental dysplasia of the hip

Get full access to this article

View all access options for this article.

References

Kumar,

E.M.

Kumar,

G.Y.

Noorudheen,

, Challenges and outcome of total hip arthroplasty in patients with developmental dysplasia of the hip: a clinical series with a spectrum of disease manifestation and technical notes. International Journal of Research in Orthopaedics, 2018. 4(2): 333-341.

Baz,

A.B.

, et al., Treatment of high hip dislocation with a cementless stem combined with a shortening osteotomy. Archives of Orthopaedic and Trauma Surgery, 2012. 132(10): 1481-1486.

Flanagin,

B.A.

, et al., Total hip arthroplasty followed by traction and delayed reduction for Crowe IV developmental dysplasia of the hip. The Journal of Arthroplasty, 2013. 28(6): 1052-1054.

Furnes,

, et al., Hip disease and the prognosis of total hip replacements. Bone & Joint Journal, 2001. 83(4): 579-579.

Gulbahce,

, et al., Total hip arthroplasty performed in 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. 2018.

Sofu,

, et al., Transverse subtrochanteric shortening osteotomy during cementless total hip arthroplasty in Crowe type-III or IV developmental dysplasia. The Journal of Arthroplasty, 2015. 30(6): 1019-1023.

Zhu,

, et al., Total hip arthroplasty with a non-modular conical stem and transverse subtrochanteric osteotomy in treatment of high dislocated hips. The Journal of Arthroplasty, 2015. 30(4): 611-614.

Carlsson,

A.M.

, Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain, 1983. 16(1): 87-101.

Harris,

W.H.

, Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end result study using a new method of result evalua tion. J Bone Joint Surg (Am), 1969. 51(4): 737.

10.

Çelik,

, et al., Translation, cross-cultural adaptation, and validation of the Turkish version of the Harris Hip Score. Hip International, 2014. 24(5): 473-479.

11.

Youdas,

J.W.

, et al., Determining meaningful changes in pelvic-on-femoral position during the Trendelenburg test. Journal of Sport Rehabilitation, 2007. 16(4): 326.

12.

Salaffi,

, et al., Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. European Journal of Pain, 2004. 8(4): 283-291.

13.

Chahal,

, et al., The minimal clinical important difference (MCID) and patient acceptable symptomatic state (PASS) for the modified Harris Hip Score and Hip Outcome Score among patients undergoing surgical treatment for femoroacetabular impingement. Orthopaedic Journal of Sports Medicine, 2014. 2(7_suppl2): 2325967114S00105.

14.

Pedersen,

, et al., Registration in the Danish Hip Arthroplasty Registry Completeness of total hip arthroplasties and positive predictive value of registered diagnosis and postoperative complications. Acta Orthopaedica Scandinavica, 2004. 75(4): 434-441.

15.

Sucato,

D.J.

, et al., Gait, hip strength and functional outcomes after a Ganz periacetabular osteotomy for adolescent hip dysplasia. Journal of Pediatric Orthopaedics, 2010. 30(4): 344-350.

16.

Reikerås,

Haaland,

J.E.

Lereim,

, Femoral shortening in total hip arthroplasty for high developmental dysplasia of the hip. Clinical Orthopaedics and Related Research? 2010. 468(7): 1949-1955.

17.

Sofu,

, et al., Cementless total hip arthroplasty in patients with Crowe type-4 developmental dysplasia. Hip International, 2013. 23(5).

18.

Kılıçolu,

Ö.İ.

, et al., Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation. The Journal of Arthroplasty, 2013. 28(1): 117-125.

19.

Desteli,

E.E.

, et al., Clinical results of cementless total hip arthroplasty with shortening osteotomy for high dislocation with developmental dysplasia. Acta Orthop Belg, 2015. 81(1): 30.

20.

Decking,

, et al., Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip. Archives of Orthopaedic and Trauma Surgery, 2003. 123(7): 357-362.

21.

Tadross,

D.T.

Lunn,

D.E.

Redmond,

A.C.

, The influence of surgical approach on outcomes of total hip arthroplasty. Orthopaedics and Trauma, 2016.

22.

Erdemli,

, et al., Total hip arthroplasty in developmental high dislocation of the hip. The Journal of Arthroplasty, 2005. 20(8): 1021-1028.

23.

Masonis,

J.L.

, et al., Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. The Journal of Arthroplasty, 2003. 18(3): 68-73.

24.

Krych,

A.J.

, et al., Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia: surgical technique. JBJS, 2010. 92(Supplement_1_Part_2): 176-187.

The outcome of total hip arthroplasty in patients with developmental dysplasia of the hip