The effect of previous surgical treatment on the outcome of total hip replacement in young patients with dysplastic coxarthrosis

Abstract

Introduction Hip dysplasia of various genesis is recognized as a common cause of coxarthrosis. Total hip replacement (THR) is the operation of choice for the patients with the final stage of the pathological process. There are different opinions on the impact of previous surgical treatment of hip dysplasia on THR. The aim of the study was to explore the effects of previous surgical treatment on the outcomes of THR in young patients with dysplastic and secondary coxarthrosis. Material and methods Surgical outcomes of 78 patients (58 females and 20 males; 91 joints) with dysplastic and secondary coxarthrosis (age 14-30 years, average age 24.3 ± 4.3 years) treated witrh THR were retrospectively reviewed. Patients were assigned to two groups. Group I (control) included 27 patients (33 joints) with dysplastic coxarthrosis primarily treated with THR. Group II (treatment group) included 51 patients (58 joints) who had previously undergone THR. Results Patients of group II demonstrated longer duration of surgery by 47.89 %, greater blood loss by 16.92 % and the higher complication rate by 42.1 %. Discussion The treatment group showed a significantly increased frequency of late complications in the form of implant instability. Patients of group II demonstrated better functional results estimated with HHS as compared to the outcomes of patients of group I. Conclusion Hip reconstructions performed earlier were associated with technical difficulties, aggressive THR procedure, a greater risk of late complications, but showed no significant effect on the outcomes.

Keywords

• coxarthrosis
• hip dysplasia
• organ preservation surgery
• osteotomy
• total hip replacement