Release and balance of the soft tissue in total hip arthroplasty for patients with Crowe III and IV type developmental dysplasia of hip

Objective To summarize the surgical experience of release and balance of soft tissues around hip in total hip arthroplasty for patients with severe hip dysplasia.Methods From January 2001 to January 2006,29 patients(31hips)of adult dysplastia of hip were included in the study.Among them, there were 22 females and 7 males,age from 38 to 65 years with average of 53 years.According to Crowe classification system,there were 22 in type Ⅲ,9 in type Ⅳ,and Harris score was 42.6 preoperatively. Total hip arthroplasty was performed via lateral approach.All the acetabular cups were reconstructed at the original anatomic location through release of soft tissue around hip to restore limb length,and techniques of balance of soft tissue were applied to extend force arm of hip abductor and improve its function.Results All the patients had restoration of limb length(ranged from 2.5 cm to 4.5 cm).One case of postoperative dislocation was occurred due to slight large of acetabular abduce angle.Follow-up for 1-5 years(average 3.2 years)in 29 patients,the Harris score increased to 85.4 postoperatively.All hips had released from pain and functioned well.Conclusions In order to restoration anatomic structure and physiologic function of affected hip,the technique of release and balance of soft tissues around hip should be applied and cautioned in arthroplasty of dysplastie hip.