{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:50:59Z","timestamp":1782471059793,"version":"3.54.5"},"reference-count":29,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Background: Developmental dysplasia of the hip (DDH) is one of the leading causes of secondary hip osteoarthritis and frequently results in severe anatomical alterations that make total hip arthroplasty (THA) technically demanding. Restoration of hip biomechanics, limb length, and joint stability remains challenging, particularly in patients with moderate-to-severe dysplasia. Objective: To evaluate the clinical and radiographic outcomes of cementless total hip arthroplasty combined with soft-tissue balancing, with or without acetabular reconstruction using autologous femoral head graft, in patients affected by osteoarthritis secondary to DDH. Methods: A retrospective single-center case series was conducted on eight female patients (mean age 53.9 \u00b1 14.6 years; range 33\u201380 years) who underwent primary cementless THA for DDH-related osteoarthritis between 2019 and 2025. Clinical outcomes were assessed using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36). Radiographic evaluation included implant positioning, osteolysis, heterotopic ossification, bone graft incorporation, and leg-length discrepancy. Data normality was assessed using the Shapiro\u2013Wilk test. Preoperative and postoperative outcomes were compared using paired Student\u2019s t-test and confirmed with the Wilcoxon signed-rank test. Implant survival and revision-free status were recorded throughout the follow-up period. Results: At a minimum follow-up of 12 months (range 12 months\u20136 years), significant improvements were observed in all clinical outcome measures. Mean HHS increased from 49.3 \u00b1 2.5 preoperatively to 90.4 \u00b1 2.7 postoperatively (p &lt; 0.001), while mean WOMAC decreased from 53.5 \u00b1 5.6 to 7.4 \u00b1 3.3 (p &lt; 0.001). Mean SF-36 improved from 47.2 \u00b1 3.8 to 89.9 \u00b1 3.2 (p &lt; 0.001). Wilcoxon analysis confirmed the statistical significance of these findings (all p = 0.0078). Radiographic assessment demonstrated satisfactory implant positioning and stable fixation in all patients, with no evidence of osteolysis or implant loosening. Minor complications included one intraoperative periprosthetic femoral fracture treated successfully with cerclage wiring, two cases of Brooker grade I\u2013II heterotopic ossification, and one case of minimal graft resorption without clinical consequences. No revision procedures were recorded during follow-up, and implant survival was 100%. Conclusions: Cementless THA combined with selective soft-tissue balancing provides excellent clinical, functional, and radiographic outcomes in patients with osteoarthritis secondary to DDH. This approach significantly improves hip function and quality of life while ensuring stable implant fixation, low complication rates, and excellent mid-term implant survival.<\/jats:p>","DOI":"10.3390\/jfmk11030251","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T08:43:57Z","timestamp":1782463437000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Radiographic Outcomes of Cementless Total Hip Arthroplasty for Osteoarthritis Secondary to Developmental Dysplasia of the Hip: A Retrospective Study with Minimum 12-Month Follow-Up"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-8155","authenticated-orcid":false,"given":"Francesco","family":"Liuzza","sequence":"first","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfrancesco","family":"Pirri","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Serra","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Aureli","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-6755","authenticated-orcid":false,"given":"Fernando","family":"De Maio","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7460-282X","authenticated-orcid":false,"given":"Pasquale","family":"Farsetti","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rovere","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Traumatology, Department of Clinical Science and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1007\/s43465-024-01157-9","article-title":"Developmental Dysplasia of the Hip and Laterality: The Importance of Graded Severity of the Contralateral Hip","volume":"58","author":"Schaeffer","year":"2024","journal-title":"Indian J. 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