- Crowe Classification: (also see Paprosky classification and total hip replacement menu)
- type of classification for severity of adult DDH;
- grade 1: hips have less than 50% subluxation;
- grade 2: hips have between 50% to 75% subluxation;
- usually do not have leg length inequality or loss of bone stock;
- w/ low dislocation, femoral head articulates w/ false acetabulum which partially covers the true acetabulum;
- on x-ray there may be 2 overlapping acetabula:
- inferior part of the false acetabulum is an osteophyte which is located the level of the superior rim of the true acetabulum;
- visible part of the true acetabulum can therefore be missed;
- reference:
- The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty.
- grade 3: hips have between 75% to 100% subluxation;
- complete loss of superior acetabular roof;
- may have thin medial wall;
- anterior and posterior columns are intact;
- consider medial protrusion technique
- references:
- Results of total hip arthroplasty for Crowe Type III developmental hip dysplasia.
- [Reconstruction of the Acetabulum with Structured Bone Graft in Press-Fit Technique.]
- Acetabular Cup Revision With the Use of the Medial Protrusio Technique at an Average Follow-up of 6.6 Years.
- Durable Fixation Achieved With Medialized, High Hip Center Cementless THAs for Crowe II and III Dysplasia
- grade 4: hips have more than 100% subluxation;
- true acetabulum is deficient but remains recongnizable;
- if cup is placed at level of true acetabular then a subtrochanteric shortening osteotomy is often required;
- Total hip arthroplasty for Crowe type IV developmental hip dysplasia: a long-term follow-up study.
- Cementless Total Hip Arthroplasty and Limb-Length Equalization in Patients with Unilateral Crowe Type-IV Hip Dislocation.
- Total Hip Arthroplasty with Shortening Subtrochanteric Osteotomy in Crowe Type-IV Developmental Dysplasia
- Total Hip Arthroplasty with Shortening Subtrochanteric Osteotomy in Crowe Type-IV Developmental Dysplasia: Surgical Technique
- Treatment of Crowe IV high hip dysplasia with total hip replacement using the Exeter stem and shortening derotational subtrochanteric osteotomy.
- Greater Trochanter Osteotomy With Cementless THA for Crowe Type IV DDH
- Subtrochanteric shortening osteotomy combined with cemented total hip arthroplasty for Crowe group IV hips
- Wake-up Test in Total Hip Arthroplasty With High-riding Developmental Dysplasia
- Total hip arthroplasty followed by traction and delayed reduction for Crowe IV developmental dysplasia of the hip.
- Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip.
- references:
-Total hip replacement in congenital dislocation and dysplasia of the hip.
- Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia.
- Total hip arthroplasty with cement and without acetabular bone graft for severe hip dysplasia. A concise follow-up, at a minimum of twenty years, of a previous report..