Successful Outcome Following Bilateral Dual-Mobility Total Hip Arthroplasty For Neglected Developmental Dysplasia Of The Hip – A Case Report

OBJECTIVES: Developmental dysplasia of hip (DDH) is a disorder of abnormal development of dislocation of hip secondary to casular laxity and mechanical factor. Arthroplasty maybe challenging with acetabular dysmorphia affecting cup placement which may increase the risk of dislocation post procedure RESULTS: We describe a case of 60 years old lady that with history of difficulty in walking since childhood but not taken any definitive treatment. She presented with complaint of pain in both hips for last 5 years ago. On examination, patient was walking with waddling gait. All hip movements were painfully restricted. 3 cm shortening was present on left side. Radiological examination, Radiographs of the pelvis revealed proximally migrated dysplastic head of femur with dysplastic shallow empty acetabulum. Patient was underwent for right dual-mobility total hip arthroplasty (THA) first with acetabular shelf grafting. Following successful results, she opted for a similar implant on the left side. Harris Hip Score was used to evaluate the functional outcome of hip. Prior of operation, the score was 40, then after operation, the score was 80. The patient is currently two years from her surgery and ambulating with one stick CONCLUSION: In untreated developmental dysplasia of hip, concentric reduction of prosthetic hip is technically demanding. Cup coverage and restoration of normal hip biomechanics remain the most important issues. Acetabulum is hypoplastic with narrow femoral medullary canal. Dual-mobility arthroplasty is an option with potentially reduced wear rates and improved articulating stability; particularly in cases of DDH where placement maybe sub-optimally placed due to existing acetabular dysmorphia. This case highlights success in treating patients with DDH using dual-mobility arthroplasty. In untreated developmental dysplasia of hip, concentric reduction of prosthetic hip is technically demanding. Cup coverage and restoration of normal hip biomechanics remain the most important issues. Acetabulum is hypoplastic with narrow femoral medullary canal. Dual-mobility arthroplasty is an option with potentially reduced wear rates and improved articulating stability; particularly in cases of DDH where placement maybe sub-optimally placed due to existing acetabular dysmorphia. This case highlights success in treating patients with DDH using dual-mobility arthroplasty.