Total hip arthroplasty in the treatment of developmental dysplasia of the hip

Total hip arthroplasty (THA) is the preferred treatment for patients with severe arthritis of the hip secondary to developmental hip dislocation or dysplasia. However, THA may be difficult due to bone and soft tissue problems that arise from hip dislocation or dysplasia. Another problem is that patients are usually young, which may affect the long-term survival of the prosthesis. Either cemented or uncemented components can be used depending on bone structure and bone stock. Uncemented components are more preferable because of the young age of the patients. From a biomechanical standpoint, the placement of the acetabular component in its true anatomical location is the main goal for survival and better functional results of THA. To ascertain the stability of the acetabular component, superior grafting, controlled medial wall perforation (medialization), or giving the position of a high hip center may be used. On the femoral side, various femoral components may be used with or without a shortening osteotomy. In this article, reconstruction options for developmental hip dysplasia are discussed depending on acetabular and femoral features of the deformity.