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Crowe classification may not clearly indicate degree of hip dysplasia
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ORLANDO, Fla. — An increase in Crowe classification for hip dysplasia may not be indicative of the degree of dysplasia, as the anatomical distortions sometimes vary greatly within each classification, according to a presenter here.
“In arthroplasty for hip dysplasia, you may want to use the Crowe classification but recognize it may not be entirely predictive of your actual deformity,” Kenneth A. Gustke, MD, said during his presentation at the Current Concepts in Joint Replacement Winter Meeting. “You need to come to these surgeries with a special bag of tricks and tools, such as smaller cups for Crowe IVs, augments for IIIs and modular fluted stems for all.”
Kenneth A. Gustke
He added, “Be prepared to do a femoral osteotomy because it is hard to predict when you may need that to correct your femoral anteversion.”
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Crowe I classifications can be corrected by placing the component near the acetabulum for 80% coverage. Crowe II deformities require more subluxation, but components can still be placed more proximally, Gustke said. For Crowe III classifications, medializing the deformity, using smaller cups or tools, such as allograft or metal augments, can help correct the deformity. Crowe IV classifications are less of a problem in that anatomic acetabulum has not been violated, Gustke said. Therefore, he recommends the use of smaller diameter components placed in the acetabulum, as problems are mainly on the femoral side.
Reference:
Gustke KA. Paper#29. Presented at: Current Concepts in Joint Replacement Winter Meeting; December 12-15, 2012; Orlando, Fla.
Disclosure: Gustke has no relevant financial disclosures.