Retrospective Review of Outcomes of Total Hip Arthroplasty in Developmental Dysplasia of the Hip in Adults

Developmental dysplasia of the hip (DDH) is a major cause of hip arthritis in young adults. Total hip arthroplasty (THA) is an effective treatment for DDH, but few studies have examined mid- (5 to 10 years) to long-term (>10 years) outcomes. This study reports the long-term survivorship, clinical, and radiographic outcomes of THA in DDH patients. A total of 255 patients were included from our retrospective review of THAs from January 2004 to January 2022. Among these cases, 214 (83.9%) were women, the mean age at the time of surgery was 46 years (range, 18 to 87), and the mean follow-up was 8.3 (range, 0.05 to 21.08) years. Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery for any reason. Kaplan-Meier survivorship for patients who underwent THA to treat DDH due to all-cause failure was 93.4% (95% CI [confidence interval]: 90.3 to 96.5) at five years, 92.5% (95% CI: 89.0 to 95.6) at 10 years, and 90.9% (95% CI: 86.2 to 94.0) at 15 years. The overall rate of revision of the index surgery was 18 of 255 (7.1%). These complications included pain (seven), dislocation (four), aseptic loosening of the cup (three), periprosthetic fracture (two), complete foot drop (one), and infection (one). Kaplan-Meier all-cause survivorship for Hartofilakidis A, B, and C was also conducted and showed no significant differences. The mean femoral offset improved from a preoperative value of 12.18 cm (SD 1.35) to a postoperative value of 11.65 cm (SD 1.05) (P < 0.001). The rate of femoral nerve palsy was 0.78%. Our study suggests THA for DDH is a viable treatment, providing excellent mid-term to long-term survivorship, clinical, and radiographic outcomes with a low complication rate. Future research should evaluate patient-reported outcomes and long-term follow-up in larger cohorts.