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The Journal of Bone and Joint Surgery (American) 85:1725-1732 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Intermediate-Term Results After Hybrid Total Hip Arthroplasty for the Treatment of Dysplastic Hips

Hiroshi Ito, MD, Takeo Matsuno, MD, Akio Minami, MD and Yoshimitsu Aoki, MD

Investigation performed at the Departments of Orthopaedic Surgery, Asahikawa Medical College, Asahikawa, and Hokkaido University School of Medicine, Sapporo, Japan

Hiroshi Ito, MD
Takeo Matsuno, MD
Department of Orthopaedic Surgery, Asahikawa Medical College, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan. E-mail address for H. Ito: itobiro{at}asahikawa-med.ac.jp

Akio Minami, MD
Yoshimitsu Aoki, MD
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita-ku Kita-15 Nishi-7, Sapporo 060-8638, Japan

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: In recent studies, good intermediate-term results have been reported after primary hybrid total hip arthroplasty (a cementless acetabular component with a cemented femoral stem) for the treatment of primary osteoarthritis. However, few studies have described the results of this technique in patients with developmental dysplasia of the hip.

Methods: One hundred primary hybrid total hip replacements were performed in ninety patients to treat degenerative arthritis of the hip secondary to developmental dysplasia. Seventy-one patients (eighty-one hips) were available for clinical and radiographic evaluation. The average duration of follow-up was 10.6 years. There were ten men and sixty-one women. Seventy hips were classified as type 1 (dysplasia); seven, as type 2 (low dislocation); and four, as type 3 (high dislocation), according to the classification system of Hartofilakidis et al.

Results: At the time of the final follow-up, the average Harris hip score was 86 points. Structural autograft was used in fifteen hips to supplement acetabular coverage. Within five years postoperatively, the acetabular component in six of the fifteen hips had an average of 4.5 mm of vertical migration and an average increase in vertical rotation of 3°, but the position appeared to stabilize thereafter. Revisions were performed in two hips because of recurrent dislocation. No acetabular or femoral component was revised because of aseptic loosening. Osteolysis was identified around two acetabular components and two femoral components. The average rate of polyethylene wear was 0.09 mm per year.

Conclusions: Hybrid total hip arthroplasty for the treatment of symptomatic degenerative arthritis secondary to developmental dysplasia provides favorable results at intermediate-term follow-up. With lower grades of dysplasia, the majority of patients can be treated effectively without a structural bone graft by placement of the cementless acetabular component at a medial or high position.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.


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