Total hip arthroplasty combined with femoral head autograft for Crowe type II and type III developmental dysplasia of hip]

To evaluate the efficacy of total hip arthroplasty (THA) combined with femoral head autograft for Crowe type II and type III developmental dysplasia of the hip (DDH).From January 2001 to January 2004, THA was performed for 23 patients (29 hips) with osteoarthritis secondary to DDH. There were 20 females (26 hips) and 3 males (3 hips) with an average age of 52 years (range 43-65 years). Unilateral DDH occurred in 17 patients and bilateral DDH occurred in 6 patients. Based on radiographic classification of Crowe, there were 17 cases (20 hips) of type II and 6 cases (9 hips) of type III. The length difference was (2.9 +/- 0.8) cm between two lower limbs of the unilateral DDH patients. The Harris scores were 43.6 +/- 13.8 preoperatively. The standard procedure of THA was performed in 3 patients (4 hips), the structural femoral head autograft for restoring normal level of rotating center of the acetabulum in other patients.The incision healed by first intention in all patients. No patient suffered complications after operation. The duration of follow-up ranged from 4 to 7 years (average 5.6 years). The X-ray films showed bony healing between the grafted bone and the ilium in all patients. At last follow-up, the length difference was (0.9 +/- 0.2) cm between two lower limbs and the Harris score was 86.3 +/- 6.4; showing statistically differences (P < 0.05) when compared with preoperation. The X-ray films showed no dislocation of acetabulum, and femoral prosthesis, and no signs of dislocation, absorption and collapse of the grafted bone.THA combined with structural femoral head autograft for patients with osteoarthritis secondary to DDH can obtain favorable results. This method can restore normal level of rotating center of the acetabulum, provide reliable acetabular fixation, and restore acetabular bone stock in patients with Crowe type II and type III DDH.