[Soft tissue balancing in the total hip arthroplasty for severe developmental dysplasia of the hip in adults].
OBJECTIVE
To assess clinical result of soft tissue balancing in primary total hip arthroplasty for severe developmental dysplasia of the hip in adults.


METHODS
From December 2000 to August 2006, 26 primary cementless total hip arthroplasties combined with soft tissue balancing were performed in 21 cases for the treatment of severe developmental dysplasia of the hip. Patients were classified as type III (20 hips) and type IV (6 hips) according to Crowe classification. All acetabular cups were placed in their original anatomic location by soft tissue releasing and subtrochanteric shortening osteotomy. Thereafter, postoperative clinical and radiological results were evaluated.


RESULTS
The mean length of follow-up was 4.8 years (range, 13 months-7 years). Limp improved by at least one grade in 62% of the cases. Leg-length discrepancy was corrected significantly and osteotomy was undertaken in 13 hips with a mean decrease length of 0.9 cm by effective releasing. Harris scores improved significantly from a mean of 41.2 preoperatively to 89.6 postoperatively. No dislocations, infections and prosthesis loosening were found at the final follow-up evaluation.


CONCLUSIONS
Soft tissue balancing in total hip arthroplasty can facilitate acetabular reconstruction to normalize the hip center in severe developmental dysplasia of the hip, as a result, satisfactory short-term result can be obtained by restoring normal function and anatomic structure.
Zhang
Lei
L
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, China.
Yu
Lie-dao
LD
Yang
Guo-jing
GJ
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D003238:Connective Tissue / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome