Outcomes after THA in patients with high hip dislocation after childhood sepsis

Abstract

To ascertain whether THA in patients with high dislocation after childhood sepsis would relieve pain and improve function, we assessed the rate of postoperative infection, improvement in Harris hip and WOMAC scores, and improvement in range of motion after the THA in 62 patients (62 hips) with high dislocation (Crowe Type 4) after childhood sepsis. The revision rate and the incidence of complications also were assessed. The mean age of the patients was 47.5 years. The minimum followup was 13 years (mean, 15.2 years; range, 13-17 years). One patient had persistent infection. The mean preoperative Harris hip score of 55 points improved to 89 points at the final followup, and the mean preoperative WOMAC score of 65 points improved to 42 points. The mean combined preoperative arc of range of motion of 197 improved to 275. Four cups (6%) and three stems (5%) were revised. Complications developed in nine hips (15%), but the rate of infection was low. Improved surgical technique and design of components provided favorable results for total hip replacement performed for complications of childhood sepsis in these young and active patients. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. © 2009 The Association of Bone and Joint Surgeons.