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      Changes in Distribution of Lower Limb Alignment After Total Hip Arthroplasty for Crowe IV Developmental Dysplasia of the Hip

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          Abstract

          Purpose

          The purpose of this study was to evaluate the distribution of lower limb alignment in Crowe IV developmental dysplasia of the hip (DDH) before and after total hip arthroplasty (THA).

          Patients and Methods

          We retrospectively included 64 Crowe IV DDH patients (87 hips) who underwent THA between February 2010 and May 2019. Radiographic parameters were measured on full limb length standing anteroposterior radiographs, including hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), anatomical lateral distal femoral angle (aLDFA), and anatomical tibiofemoral angle (aTFA).

          Results

          HKA improved from 176.54°±3.52° preoperatively to 179.45°±4.31° at the last followup (P<0.001). According to the preoperative HKA, 40 hips were defined as knee valgus alignment. The majority of them were characteristic of a valgus mLDFA and a valgus or neutral mMPTA (35%, 47.5%). After THA, there were still 22 hips defined as knee valgus alignment. More than 50% of them were characteristic of a valgus mLDFA and a neutral mMPTA. Five hips (22.7%) revealed valgus alignment in both mLDFA and mMPTA. Twenty-one hips (24.1%) remained knee valgus alignment before and after surgery. One hip, defined as neutral alignment, preoperatively turned into valgus alignment after surgery.

          Conclusion

          Both preoperative and postoperative sources of valgus alignment were mainly from the femoral side among Crowe IV DDH patients. THA mainly played a positive role in the reconstruction of lower limb alignment in these patients.

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          Most cited references 24

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          The Measurement of Observer Agreement for Categorical Data

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            Long-Term Results of Cementless Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy in Crowe Type IV Developmental Dysplasia

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              Total hip arthroplasty for adult hip dysplasia.

              Preoperative planning is essential to define anatomy, clarify the operative approach and exposure, and ensure that suitable implants are available.Concerns exist regarding the long-term effectiveness and safety of hip resurfacing arthroplasty for the young dysplastic hip.In light of current evidence, concerns exist regarding the use of metal-on-metal articulations for hip arthroplasty in the young dysplastic hip.The ideal bearing surface is not known, although the longest data available support the use of metal-on-polyethylene.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                tcrm
                tcriskman
                Therapeutics and Clinical Risk Management
                Dove
                1176-6336
                1178-203X
                03 May 2021
                2021
                : 17
                : 389-396
                Affiliations
                [1 ]Department of Orthopedics, Chinese People’s Liberation Army General Hospital , Beijing, People’s Republic of China
                [2 ]Medical School of Chinese People’s Liberation Army , Beijing, People’s Republic of China
                Author notes
                Correspondence: Yonggang Zhou; Guoqiang Zhang Department of Orthopedics, Chinese People’s Liberation Army General Hospital , Fuxing Road, Haidian District, Beijing, People’s Republic of ChinaTel +8613801287599; +8613601210743 Email ygzhou301@163.com; gqz301@126.com
                [*]

                These authors contributed equally to this work

                Article
                302298
                10.2147/TCRM.S302298
                8104987
                © 2021 Sun et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 6, Tables: 12, References: 24, Pages: 8
                Funding
                Funded by: did not receive any specific grant from funding agencies in the public;
                This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
                Categories
                Original Research

                Medicine

                total hip arthroplasty, crowe iv, developmental dysplasia of the hip, knee alignment

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