Department of Orthopaedics and Traumatology, Ufuk University, TurkeyFulltext PDF
Introduction: The purpose of this paper was to evaluate the functional and clinical results of the developmental high-dislocated hip patients applied subtrochanteric transverse shortening osteotomy fixed axially and rotationally by cementless femoral stem and the acetabular component placed into the anatomical place.
Methods: In this retrospective study, the results of fifty consecutive primary cementless total hip arthroplasty in twenty-eight patients (twenty-six female and two male) all of whom had Crowe 4 (Hartofilakidis type 3) high dislocations were evaluated. The arthroplasty was performed in combination with a subtrochanteric transverse shortening osteotomy and Zweymüller femoral stem (SL plus) without any fixation instruments for the osteotomy site and with placement of the acetabular component at the level of anatomic hip center.
Results: The mean Harris Hip Score increased from 24.03 points preoperatively to 82.88 points at the time of final follow up. Ten of the fifty hips had an early or late complications and/or revisions. None of the subtrochanteric osteotomies were resulted with nonunion and no other complications concerning the femoral site were encountered. There was one case of isolated loosening of acetabular component. Two hips dislocated postoperatively which were treated by closed reduction and bracing for 12 weeks. One sciatic neurapraxic injury was identified which resolved conservatively within 6 month time. Intraoperative femoral fracture was seen in three hips. One of them on the proximal part (trochanteric site) and the other two on the distal femur. All were fixed by cerclage and cables. Heterotopic ossification was seen in three hips.
Conclusion: Subtrochanteric shortening osteotomy and cementless total hip arthroplasty for the treatment of Crowe 4 (Hartofilakidis type 3) high dislocations of the hip were associated with high rates of successful fixation of the femoral component and the acetabulum. Adequate union has seen at the osteotomy site within the eight weeks’ time without any complications.
Güçlü B. Cementless Total Hip Arthroplasty with Transverse Subtrochanteric Shortening Osteotomy in Developmental High Dislocated Hips and Minimum 6 Years Follow-up. Ann Orthop Surg Res. 2019; 2(1): 1007.