IL FEMORE DISPLASICO NELLA PROTESIZZAZIONE DELL’ANCA Dysplasic femur in total hip replacement

Background. Total hip arthroplasty is actually the most common solution for the treatment of hip dysplasia. Even if the anatomical changes of the acetabular region are more often involved in making this procedure challenging, also the dysplasic femur hasto be considered in a precise pre-operative surgical planning. An increase of the femoral neck anteversion togheter with an alteration of the inclination are the most common anatomical femoral problems. A reduction in the diameter of the medullary canal and a straightening of the proximal medial curvature of the femur is also described. These anatomical alterations are worse in the presence of an hip subluxation or luxation. Challenging in THA can arise also after femoral osteotomies. Aims. Aim of this work is to describe, following current issues present in literature and authors personal experience, indications and results in total hip arthroplasty in the presence of femoral dysplasia. Methods. A review of the literature and a retrospective revision of our patients that underwent total hip arthroplasties in dysplasic hips is described. Results. From our experience on 56 femoral stems, an uncemented cone-shaped stem is preferred even if anatomical stems were also used in selected patients with a good outcome. Conclusion. Since a wide variability across the anatomical changes is present in different individuals, an accurate preoperative CT scanning of the proximal femur has to be taken for making a correct decision before an hip replacement for dysplasic anomalies.