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The Journal of Bone and Joint Surgery, Vol 65, Issue 8 1099-1108, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
Complex total hip replacement for dysplastic or hypoplastic hips using miniature or microminiature components
ST Woolson and WH Harris
We analyzed the preoperative and perioperative data on sixty-nine
consecutive complex total hip replacements performed in fifty-seven
patients using miniature or microminiature custom-made femoral components.
The patients' average age was 45.7 years. The preoperative diagnosis was
congenital dysplasia or dislocation of the hip in 72 per cent of the hips.
Acetabular bone grafts were required in thirty-seven of the sixty-nine
hips. Operative complications occurred in thirteen (19 per cent) and
postoperative dislocation occurred in eleven (16 per cent) of the
sixty-nine hips. Fifty-five hips in forty-seven patients were followed for
a minimum of two years, the average follow-up being 4.8 years and the
longest, 9.8 years. All acetabular grafts united. Loosening of one or both
prosthetic components occurred in ten (18 per cent) of the fifty-five hips
(twelve of the 110 components became loose). There were no instances of a
stem bending or fracturing, despite the small size of the femoral
components. Eight hips (14.5 per cent) had undergone revision, six for
painful loose components and two for recurrent dislocation. For the
forty-seven hips that were not revised, the average Harris hip score rose
from 43 points preoperatively to 80 points postoperatively.
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