The result of total hip arthroplasty in a patient with congenital dislocation of the hip based on the individual characteristics of the iliac vessels(clinical case)

Abstact. Primary hip replacement in patients with congenital high hip dislocation is a technically complex manipulation, according to some authors requiring an individual approach to each clinical case. In this report, we share the results of primary hip replacement in a patient with severe hip dysplasia. The proposed option of preoperative planning and operation technique is based on the individual anatomical features of the particular patient. Using the CT data, a 3D model of hip bones with the main neurovascular bundles of this area was recreated for a full three-dimensional preoperative surgery planning. We decided to use the individual acetabular component because of the expected shortage of its bone coverage. In particular, we took into account the optimal positioning of the rotation center, increased possibilities of screw fixation and contact area, as well as careful planning of screw projections based on the passage of the neurovascular bundle. Also, this tactic is due to the variability of the topography of the iliac vessels in patients with hip dysplasia and the risk of damage during the implantation of the acetabular component. In the postoperative period, excellent clinical and radiological results were obtained, which allows us to offer this method of hip replacement as an alternative to standard methods of hip arthroplasty in patients with congenital high hip dislocation.