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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate professor Trude Gundersen, University of Bergen
- Second opponent: Consultant orthopaedic surgeon Martin Gottliebsen, Aarhus University Hospital
- Third member and chair of the evaluation committee: Professor Kristin Bjørnland, University of Oslo
Chair of the Defence
Adjunct Professor, Inger Holm, University of Oslo
Principal Supervisor
Adjunct Professor Jens Ivar Brox, University of Oslo
Summary
Developmental dysplasia of the hip (DDH) is a congenital or acquired condition of the hip joint of varying severity, ranging from a steep acetabular socket where the femoral head is located in the socket to hip dislocation where the femoral head has migrated out of the maldeveloped socket. Early diagnosis and treatment is important for the development and normalization of the hip joint. If primary treatment does not lead to a good result, osteoarthritis (OA) is often seen in adult life. To avoid this, surgical measures may be indicated in childhood or adolescence. One such option is the Spitzy shelf procedure, which aims to increase the coverage of the femoral head by the acetabulum and reduce the risk of later OA. In patients with persistent high hip dislocation and pain, a total hip arthroplasty (THA) and shortening of the femur may be indicated. In such cases the surgical technique is more demanding, and the risk of complications is elevated compared with a standard THA.
We evaluated the long-term effects of the Spitzy shelf procedure with regards to pain and the need for later THA. The procedure had a favorable outcome in both the long and short terms, giving good pain relief and postponement of OA and subsequent THA. We also evaluated long and short-term outcomes in patients with high dislocation due to DDH, operated with femoral shortening and uncemented THA. There was a high revision rate of one of the three types of acetabular implants, which also in other studies has been shown to have a poor prognosis. There were very few revisions of the femoral implants. All the patients, revised and unrevised alike, showed good clinical results at the last follow-up comparable to patients with a standard primary THA.
Overall we found that the evaluated surgical technique for preventing early onset OA in patients with hip dysplasia was favorable, as were the results for patients with high dislocation operated with femoral shortening and uncemented THA.
Additional information
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