Total hip replacement in dwarfs

Genetic defects causing dwarfism occur in approximately 1 in 10,000 live births. Most types of dwarfism result in arthrosis of major joints resulting in significant disability. Hip replacement can offer significant improvement in quality of life, but there are inherent difficulties due to size and anatomic variations. Eight patients with short stature of less than 4 feet 10 inches underwent total hip replacement, either primary or revision, with 6 being bilateral, resulting in a total of 14 hips for study. In each case, a CT-based custom cementless femoral component was used. The average follow-up was 9 years (2–14). The average Total Harris Hip Score improved from 35 preoperatively to 66 at last follow-up. Five hips have been reoperated on. Hip replacement in dwarfs presents a complex technical challenge, but can result in significant improvement in pain, function and quality of life. CT-base custom femoral components are recommended.