Does THA Improve Social Status Among Turkish Women With Developmental Dysplasia of the Hip?

In traditional societies, patients who reach adulthood with developmental dysplasia of the hip (DDH) may be labeled "disabled" and may be considered "defective," causing them psychologic pain and problems with social interactions. In some patriarchal societies, women disproportionately experience these problems, because they may be seen as insufficient in terms of marriage and sexual intercourse owing to hip-related limitations, and they may be married through arranged marriages to people who also have disabilities. This patriarchal structure limits the ways women can engage in society and may lower their quality of life (QOL). The degree to which THA can improve the lives of women in these specific ways in a patriarchal culture has not, to our knowledge, been studied. (1) Does THA improve the social standing of young women with DDH in Turkey? (2) Does THA improve QOL of young women with DDH in Turkey? (3) Does THA improve pain and physical function in these patients? This study was a retrospective, comparative study performed at Karabük University Research and Training Hospital in Karabük, Turkey, from 2012 to 2017. A total of 217 women with DDH were followed at our center between the study dates. All of these patients were evaluated for inclusion into the study. Among these, 175 women with DDH (aged 20-45 years) were included in the study according to inclusion/exclusion criteria. We offered THA to all patients in whom surgery was technically feasible; 84 chose to undergo THA, whereas 91 declined the procedure. Whether THA had any effects on the study questions was determined by comparison of the following findings at baseline and after intervention. The social standing of patients was assessed through their marital status and proportions of employment and depression; the patients' QOL was assessed with the SF-36 at baseline for all patients and at 1 year postoperatively for those who underwent THA; and pain and dysfunction were evaluated by determination of the proportion of patients who had scoliosis, knee valgus, and knee and lumbar pain. At baseline, patients were not different in regard to all parameters except knee and lumbar pain, which were greater in those who had decided to undergo THA. The SF-36 scores of patients who underwent THA were compared with their postoperative scores as well as with the baseline scores of patients who did not undergo THA. In terms of measures of social standing, women who underwent THA appeared better at followup tha