This 2002 narrative review covers total hip arthroplasty (THA) for adults with developmental dysplasia of the hip (DDH), organized by Crowe classification. It addresses how the severity and location of acetabular and femoral deformity should drive implant selection, acetabular reconstruction strategy, and the need for femoral shortening osteotomy.
When planning THA for a Crowe III or IV DDH hip, expect to need femoral shortening — subtrochanteric osteotomy preserves the metaphysis and allows rotational correction, but keep lengthening under 3–4 cm to protect the sciatic nerve.
For the acetabulum, prioritize native bone coverage: if more than 40–50% of the cup would be uncovered or on graft at the true acetabular location, consider a high hip center — but avoid lateralizing it.
This 2002 narrative review covers total hip arthroplasty (THA) for adults with developmental dysplasia of the hip (DDH), organized by Crowe classification. It addresses how the severity and location of acetabular and femoral deformity should drive implant selection, acetabular reconstruction strategy, and the need for femoral shortening osteotomy.
When planning THA for a Crowe III or IV DDH hip, expect to need femoral shortening — subtrochanteric osteotomy preserves the metaphysis and allows rotational correction, but keep lengthening under 3–4 cm to protect the sciatic nerve.
For the acetabulum, prioritize native bone coverage: if more than 40–50% of the cup would be uncovered or on graft at the true acetabular location, consider a high hip center — but avoid lateralizing it.