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In Patients With Hip Dysplasia, Mid-Term Lower Extremities and Spine After Hip Arthroplasty Natural Course

Not Applicable
Completed
Conditions
Total Hip Arthroplasty
Interventions
Procedure: total hip arthroplasty
Registration Number
NCT06176612
Lead Sponsor
Bezmialem Vakif University
Brief Summary

Patients with developmental hip dysplasia often present to the outpatient clinic in adulthood with hip pain due to progressive hip osteoarthritis. However, they may have complaints such as limping, lumbar lordosis, lower back pain, and leg length difference. Today, the best treatment option for these patients is hip arthroplasty. Hip arthroplasty causes a high rate of functional improvement and pain relief. According to the hip arthroplasty technique applied, improvement in lameness, leg length difference and spinal curvatures is expected. The aim of our study is to show the change in postoperative spine and lower extremity curvatures after hip arthroplasty in patients with advanced developmental hip dislocation.

Detailed Description

Developmental hip dysplasia (DDH) describes the spectrum of anatomical changes in the acetabulum and proximal femur; these can cause limping, lower back pain, lumbar lordosis, and leg length variation. DDH is the main cause of degenerative arthritis of the hip and valgus deformity of the knee. The best treatment option for DDH is total hip arthroplasty (THA). During THA, the distorted anatomy of the acetabulum and proximal femur poses great difficulties. Additionally, the soft tissue can be released and the femur can be shortened while correcting the placement of the acetabulum to prevent neurological damage (sciatic nerve paralysis). Postoperative evaluations focused on assessing joint function and alleviating preoperative clinical symptoms. Some studies have examined changes in lower extremity and knee alignment after THA in patients with DDH. In patients with DDH, THA may cause genu valgus deformity due to increased lower extremity length and Q angle immediately after the operation. THA extends the lower extremity, affecting the patellofemoral joint and anterior knee pain. However, the long-term effects of THA on the alignment of the lower extremity are unclear, especially in patients with Crowe type III and IV DDH, which involves femoral shortening osteotomy. There are few studies examining changes in the knee and lower extremities as a result of THA in patients with DDH. The aim of this study is to evaluate the mid- and long-term alignment of the spine and lower extremity after THA with or without femoral shortening osteotomy in patients with unilateral DDH (Crowe type III-IV).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
Inclusion Criteria
  1. Patients with unilateral Crowe type 3 hip dysplasia
  2. Patients with unilateral Crowe type 4 hip dysplasia
Exclusion Criteria
  1. Patients with unilateral Crowe type 1 hip dysplasia
  2. Patients with unilateral Crowe type 2 hip dysplasia
  3. History of previous surgery on the hip for which surgery is planned

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Patients with Crowe type 3 or Crowe type 4 hip dysplasia who underwent total hip replacementtotal hip arthroplasty-
Primary Outcome Measures
NameTimeMethod
Mechanical axis deviation (MAD)From enrollment to the end of treatment at 2 years

the lower limb was defined as the distance from the center of the knee to the mechanical axis of the lower limb

Secondary Outcome Measures
NameTimeMethod
The medial proximal tibial angle (MPTA)From enrollment to the end of treatment at 2 years

the angle formed by the anatomic axis of the tibia and the proximal tibial joint orientation line

The femoral offset (FO)From enrollment to the end of treatment at 2 years

the vertical distances from the center of the femoral head to the center of the femoral canal

tibiofemoral angle (TFA)From enrollment to the end of treatment at 2 years

the angle formed by the line from the center of the femoral canal to the center of the knee joint and the line from the center of the knee joint to the center of the ankle joint.

The hip-knee-ankle angle (HKA)From enrollment to the end of treatment at 2 years

the angle formed by the mechanical axis of the femur and the mechanical axis of the tibia

The lateral distal femoral angle (LDFA)From enrollment to the end of treatment at 2 years

the angle formed by the anatomic axis of the femur and the distal femoral joint orientation line

Trial Locations

Locations (1)

Bezmialem Vakıf University

🇹🇷

Istanbul, Fatih, Turkey

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