Total Hip Arthroplasty Outcomes in Patients With Short Stature Due to Skeletal Dysplasia: A Two-Surgeon Experience

Introduction Total hip arthroplasty (THA) is a durable solution for end stage hip arthritis in patients with short stature associated with skeletal dysplasia, however studies have been limited with small sample sizes.1 Unique challenges exist in this population, including dysplastic acetabular morphology and small femoral canals with excessive bowing.2 This study evaluated outcomes of THA in patients with short stature due to skeletal dysplasia. We hypothesized that these patients would have excellent THA survivorship with the use of modern implants. Methods An IRB-approved two-center retrospective case series of all primary or conversion THAs in patients with short stature (height less than 150 cm) due to skeletal dysplasia were identified. Each patient had a minimum of 1-year clinical follow-up. Demographic, surgical, and outcome data were obtained. Kaplan-Meier implant survivorship was calculated. Results Twenty-one patients underwent THA by the senior surgeons through a posterior approach. Mean follow-up was 4.4 years (range, 1.1–11.2 years). The average patient was 26.6 ± 9.4 years of age, average height was 128 ± 21 cm, and the average BMI was 30.7 ± 7.7 (kg/m2). The most frequently encountered skeletal dysplasias were Spondyloepiphyseal Dysplasia and Morquio Syndrome (n=10, 48%). The Depuy S-ROM stem or Zimmer Wagner Cone femoral component were utilized in most patients. Two patients (10%) sustained complications within the first year. One patient experienced multiple dislocations and underwent both component revision, while the other patient was revised for a fracture dislocation of the femur. At mean follow up of 4.4 years, implant survivorship was 90% (Figure 1). Conclusions In patients with short stature due to skeletal dysplasia, THA offers a durable solution for end stage arthritis, with survivorship of ~90% at mean 4.4 years follow up. Modular femoral stems (S-ROM) or splined/conical stems (Wagner Cone) allow for reproducible reconstruction of the proximal femur. For any figures or tables, please contact the authors directly.