Total hip arthroplasty in patients with developmental dysplasia of the hip

Total hip arthroplasty (THA) of a developmental dysplasia of the hip (DDH) is a challenging reconstructive procedure. 50% of all THA may be due to DDH. An adequate classification like Crowe's is necessary so surgical planning can be established. In order to evaluate possible surgical approaches, keep in mind the anatomical disruption (pelvic and femoral) present in a patient with DDH. The acetabular and femoral considerations based on Crowe's classification should be overviewed to maximize outcome. The most important complication is lengthening of the sciatic nerve, and artery injury.