title: Midterm Outcome of Cementless Total Hip Arthroplasty in Crowe IV-Hartofilakidis Type III Developmental Dysplasia of the Hip.
abstract: BACKGROUND
  Developmental dysplasia of the hip (DDH) is widespread in developing countries, and treating Crowe IV-Hartofilakidis Type III DDH in adults requires the use of a highly demanding technique.
  
  
  METHODS
  We sought to determine the outcome of cementless total hip arthroplasty using Zweymüller components to treat Crowe IV-Hartofilakidis Type III DDH. Fifty-eight patients (71 hips) with a mean age of 35.8 years at time of index operation were included in our study. The average duration of follow-up was 70.5 months. The acetabular component was placed in the true acetabulum in all cases, and subtrochanteric shortening osteotomy was performed in 61 hips.
  
  
  RESULTS
  With any component revision for any reason as the end point, Kaplan-Meier survivorship analysis at 98 months revealed a cumulative survival rate for implanted components of 91.40%. The mean Harris Hip Score improved from 35.6 preoperatively to 82.9 postoperatively. There were 20 cases of intraoperative fracture, 1 case of complete nerve palsy, and 7 cases of transient nerve palsy. Revision surgery was performed in 7 patients because of cup loosening in 1, severe polyethylene wear in 4, cup breakage in 1, and dislocation in 1.
  
  
  CONCLUSIONS
  Midterm results for cementless total hip arthroplasty in patients with Crowe IV-Hartofilakidis Type III DDH was satisfactory; however, intraoperative fracture and polyethylene wear were major complications.
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Mu
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Desheng
authors.initials: D
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Boyong
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Askar
authors.initials: A
authors.lastname: Mamtimin
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Cao
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006618:Hip Dislocation, Congenital / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult
keywords: crowe IV–hartofilakidis type III developmental dysplasia of the hip; intraoperative fracture; midterm outcome; total hip arthroplasty