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Total Hip Replacement for Diastrophic Dysplasia

A diastrophic dwarf is someone who is short because of abnormal growth and development of the bone and cartilage. Diastrophic means a "bent or curved" position of the bones. This can cause changes in the bones and in the way the joints line up.

When the hip joint is affected, the condition is called diastrophic dysplasia. The result is often disabling pain and loss of motion. Walking with a limp is common. The distance a person can walk may be limited by pain.

Doctors in Finland studied the effect of replacing both hips in adults with diastrophic dysplasia. Joint implants don't last a lifetime, yet adults with this condition have a normal life span. There is a concern that doing the surgery early in life will eventually lead to a problem later on with the implant.

Hip joints on one or both sides are replaced with implants when severe pain keeps the patient from walking and doing everyday activities. The authors of this study report good results. Three-fourths of the patients were pain-free a year after the operation. One-third was able to walk without a limp and without the need of a walking aid.

These patients face unique problems associated with hip replacement. The implant may more often become infected and come loose. Fractures, nerve damage, and dislocation can occur. Many patients with diastrophic dysplasia have other deformities of the spine, knees, and feet, which can make recovery more difficult.

Even so, the authors conclude that total hip replacement is advised for patients with diastrophic dysplasia. Even fairly young adults can be included. In this study, patients ranged in age from 27 to 56 years old. The gains in function and decreased pain levels make total hip replacement a good treatment choice for this condition.

References: Ilkka Helenius, MD, PhD, et al. Total Hip Arthroplasty in Diastrophic Dysplasia. In The Journal of Bone and Joint Surgery. March 2003. Vol. 85-A. No. 3. Pp. 441-447.

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