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Survivorship and complications of total hip arthroplasty in patients with dwarfism

Survivorship and complications of total hip arthroplasty in patients with dwarfism

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Hip replacement

DOI:10.5301/hipint.5000484

Authors

Ronuk M. Modi, Michael M. Kheir, Timothy L. Tan, Gregory S. Penny, Chi-Lung Chen, Hongyi Shao, Antonia F. Chen

Abstract

Background

Total hip arthroplasty (THA) is a common procedure used to treat bony hip deformities and skeletal dysplasia in dwarfism. These surgeries are often more difficult than conventional THA as they may involve malformed joints and poor bone quality, and may require smaller prostheses. This study aims to investigate whether implant survivorship and revision rates vary among patients with and without dwarfism undergoing THA.

Methods

A retrospective case-control study was performed for 102 THAs completed between 1997 and 2014 in patients under the height threshold of 147.32 cm. This cohort was matched 1:1.5 with patients of normal height with respect to age, gender, year of surgery, and Charlson comorbidities. All cases had a minimum follow-up of 1 year. A chart review was performed to identify patient and surgical characteristics, including outcomes. Radiographs were assessed for deformity, loosening, and periprosthetic fractures among other factors.

Results

The 2-, 5-, and 10-year survivorship of THA in patients with dwarfism was 92.9%, 92.9%, and 80.7%, respectively; and 94.4%, 86.4%, and 86.4% for controls, respectively (p = 0.95). The dwarfism cohort demonstrated an OR of 3.81 and 3.02 for revision for periprosthetic fractures (p = 0.11) and mechanical wear (p = 0.21), respectively.

Conclusions

THA in patients with dwarfism achieves comparable results to a non-dwarfism population with regards to implant survivorship; however, there is a trend toward increased periprosthetic fractures and wear-related failures. Surgeons should be aware of this potentially higher risk in this population and take morphological differences into account during surgical planning and technique.

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Rothman Institute at Thomas Jefferson University, Philadelphia - USA
  • Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi - Taiwan

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