title: Total hip arthroplasty in skeletal dysplasias: patient selection, preoperative planning, and operative techniques.
abstract: Patients with substantial skeletal dysplasia and hip arthritis are poor candidates for noncustom total hip arthroplasty (THA) because of hip size and deformity. To determine the efficacy of THA via modified prostheses and surgical techniques in this population, the authors analyzed 9 consecutive THAs in 7 small-stature adults (mean height, 118.6 cm; mean weight, 47.5 kg). The Student t-test was used to test for significant (P < 0.05) differences in outcome variables. Seven hips received custom femoral components based on imaging studies. Five hips required extensive soft-tissue releases secondary to severe contractures. Follow-up radiographs (range, 24-56 months) showed adequate position of all prostheses and no loosening. Follow-up mean pain and function scores (Harris Hip Score and WOMAC Arthritis Index) showed significant improvement from preoperative levels.
authors.affiliation: Departmentof Orthopadic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Ain
authors.forename: Brett M
authors.initials: BM
authors.lastname: Andres
authors.forename: Deniz S
authors.initials: DS
authors.lastname: Somel
authors.forename: Zair
authors.initials: Z
authors.lastname: Fishkin
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Frassica
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001848:Bone Diseases, Developmental / Q000150:complications / Q000601:surgery*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D018579:Patient Selection; D011182:Postoperative Care; D011474:Prosthesis Design; D016059:Range of Motion, Articular