الفهرس 
Anatomic considerations and Biomechanics of the hip jointOnly 14 pages are availabe for public view
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Abstract
Purpose: Total hip replacement patients with a dysplastic hip is challenging. The normal anatomy about the hip joint is distorted in the presence of congenital hip dislocation and proximal migration of the femur. (1)It is a technically demanding procedure in which several problems and complications can be encountered. (2)The complexity of femoral and acetabular anatomy in these cases makes standard reconstruction technically challenging. Restoring the anatomic centre of hip rotation may require femoral osteotomy. (3)
The aim of this study was to determine the rate of union, complications and functional results in a series of patients with Crowe III and IV dysplastic hips who underwent single stage THA with or without simultaneous subtrochanteric femoral shortening osteotomy.
Methods: A retrospective study was designed in a series of 20 patients (20hips) with Crowe III or IV DDH who underwent single stage THA with or without simultaneous subtrochanteric femoral shortening osteotomy at a mean age of 33.2 years. Patients were reviewed clinically and radiographically with a minimum follow-up of 1 year. Complications were noted. Harris Hip Score (HHS) was recorded pre-operatively and at six weeks, six months and 12 months postoperatively.
Results: Hip centre was restored at the anatomic centre in 95% and near anatomic centre in 5% of cases, subtrochanteric femoral osteotomy was needed in 11 cases (55%), intraoperative femoral cracks was encountered in 3 cases (15%),union occurred in all cases with subtrochanteric shortening (100%) Mean HHS improved from 36.31 preoperatively to 87.13 at 6 months and 88.60 at 12 months. Infection and dislocation occurred in 1 case (5%) and sciatic nerve injury occurred in 1 case (5%). No cases required revision till last follow up and no patients encountered postoperative DVT or aseptic loosening.
Conclusion: Single stage THA for dysplastic hip Crowe III or IV is technically demanding and proved to be safe and effective with or without subtrochanteric femoral shortening osteotomy with restoration of anatomic hip centre.