Top

Journal of Orthopaedic Surgery and Research

Published in:

Open Access 01-12-2024 | Hip Dysplasia | Research article

Clinical efficacy of greater trochanter osteotomy with tension wire fixation in total hip arthroplasty for Crowe type IV developmental dysplasia of the hip

Authors: Jinhui Peng, Ziye Liu, Zheru Ding, Qirong Qian, Yuli Wu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Objective

The choice of osteotomy in joint replacement surgery for Crowe type IV developmental dysplasia of the hip (DDH) is a challenging and controversial procedure. In this study, we compared the clinical efficacy of a combination of greater trochanter osteotomy and tension wire fixation with that of subtrochanteric osteotomy.

Methods

We performed 15 primary total hip arthroplasty (THA) procedures between January 2016 and July 2020 on 13 patients with a combination of greater trochanter osteotomy and tension wire fixation (the GTT group) and 12 THA procedures in 11 patients using subtrochanteric osteotomy (the STO group). The mean follow-up was 2.8 years (range 2.2–4.5 years) in the GTT group and 2.6 years (range 2.5–4.3 years) in the STO group. Clinical scores and radiographic results were evaluated during the final follow-up for the 15 hips in the GTT group and 12 hips in the STO group.

Results

Postoperative Harris hip scores, implant position, and the surgery time did not differ between the treatment groups. There were no differences in preoperative leg length discrepancy LLD (P = 0.46) and postoperative LLD (P = 0.56) between the two groups. Bone union occurred within 6 months after surgery in 12 hips in the GTT group (92.3%) and in 9 hips (81.8%) in the STO group. One case in the GTT group and two cases in the STO group had nonunion, and additionally, there was one case of postoperative nerve injury in the STO group, while no symptoms of nerve damage were observed in the GTT group.

Conclusion

The GTT method demonstrated many advantages and reliable clinical results for Crowe type IV DDH patients undergoing THA. This is a surgical method that warrants further development and promotion clinically.

Yoon PW, Kim JI, Kim DO, Yu CH, Yoo JJ, Kim HJ, Yoon KS. Cementless total hip arthroplasty for patients with Crowe type III or IV developmental dysplasia of the hip: two-stage total hip arthroplasty following skeletal traction after soft tissue release for irreducible hips. Clin Orthop Surg. 2013;5(3):167–73.CrossRefPubMedPubMedCentral

Papachristou GC, Pappa E, Chytas D, Masouros PT, Nikolaou VS. Total hip replacement in developmental hip dysplasia: a narrative review. Cureus. 2021;13(4):e14763.PubMedPubMedCentral

Erdem Y, Bek D, Atbasi Z, Neyisci C, Yildiz C, Basbozkurt M. Total hip arthroplasty with rectangular stems and subtrochanteric transverse shortening osteotomy in Crowe type IV hips: a retrospective study. Arthroplasty Today. 2019;5(2):234–42.CrossRefPubMedPubMedCentral

Hartofilakidis G, Babis GC, Georgiades G, Kourlaba G. Trochanteric osteotomy in total hip replacement for congenital hip disease. J Bone Joint Surg. 2011;93-B(5):601–7.CrossRef

Reikeras O, Haaland JE, Lereim P. Femoral shortening in total hip arthroplasty for high developmental dysplasia of the hip. Clin Orthop Relat Res. 2010;468(7):1949–55.CrossRefPubMedPubMedCentral

Rasi AM, Kazemian G, Khak M, Zarei R. Shortening subtrochanteric osteotomy and cup placement at true acetabulum in total hip arthroplasty of Crowe III–IV developmental dysplasia: results of midterm follow-up. Eur J Orthop Surg Traumatol. 2018;28(5):923–30.CrossRefPubMed

Grappiolo G, La Camera F, Della Rocca A, Mazziotta G, Santoro G, Loppini M. Total hip arthroplasty with a monoblock conical stem and subtrochanteric transverse shortening osteotomy in Crowe type IV dysplastic hips. Int Orthop. 2019;43(1):77–83.CrossRefPubMed

Ahmed E, el Ibrahim G, Ayman B. Total hip arthroplasty with subtrochanteric osteotomy in neglected dysplastic hip. Int Orthop. 2015;39(1):27–33.CrossRefPubMed

Muratli KS, Karatosun V, Uzun B, Celik S. Subtrochanteric shortening in total hip arthroplasty: biomechanical comparison of four techniques. J Arthroplasty. 2014;29(4):836–42.CrossRefPubMed

10.

Huang ZY, Liu H, Li M, Ling J, Zhang JH, Zeng ZM. Optimal location of subtrochanteric osteotomy in total hip arthroplasty for crowe type IV developmental dysplasia of hip. BMC Musculoskelet Disord. 2020;21(1):210.CrossRefPubMedPubMedCentral

11.

Li C, Zhang C, Zhang M, Ding Y. Comparison of transverse and modified subtrochanteric femoral shortening osteotomy in total hip arthroplasty for developmental dysplasia of hip: a meta-analysis. BMC Musculoskelet Disord. 2014;15:331.CrossRefPubMedPubMedCentral

12.

Jin JY, Yoon TR, Park KS, Jin SY, Jung DM, Li QS. Mid-term results of total hip arthroplasty with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip. BMC Surg. 2021;21(1):9.CrossRefPubMedPubMedCentral

13.

Chen M, Luo Z, Zhu C, Wu K, Zhang X, Shang X. A reliable femoral osteotomy in total hip arthroplasty for hartofilakidis type C developmental dysplasia of the hip: proximal femoral reconstruction. J Arthroplasty. 2019;34(6):1162–7.CrossRefPubMed

14.

Lee J, Cho Y, Kim J, Kim D. Wiring techniques for the fixation of trochanteric fragments during bipolar hemiarthroplasty for femoral intertrochanteric fracture: clinical study and technical note. Hip Pelvis. 2017;29(1):44–53.CrossRefPubMedPubMedCentral

15.

Rollo G, Solarino G, Vicenti G, Picca G, Carrozzo M, Moretti B. Subtrochanteric femoral shortening osteotomy combined with cementless total hip replacement for Crowe type IV developmental dysplasia: a retrospective study. J Orthop Traumatol. 2017;18(4):407–13.CrossRefPubMedPubMedCentral

16.

Rüdiger H, Guillemin M, Latypova A, Terrier A. Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty. Arch Orthop Trauma Surg. 2017;137(11):1579–85.CrossRefPubMed

17.

Mahmood S, Mukka S, Crnalic S, Wretenberg P, Sayed-Noor A. Association between changes in global femoral offset after total hip arthroplasty and function, quality of life, and abductor muscle strength. A prospective cohort study of 222 patients. Acta Orthop. 2016;87(1):36–41.CrossRefPubMed

Title: Clinical efficacy of greater trochanter osteotomy with tension wire fixation in total hip arthroplasty for Crowe type IV developmental dysplasia of the hip
Authors: Jinhui Peng
Ziye Liu
Zheru Ding
Qirong Qian
Yuli Wu
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Hip Dysplasia
Hip-TEP
Hip-TEP
Hip Dislocation
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-023-04344-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical efficacy of greater trochanter osteotomy with tension wire fixation in total hip arthroplasty for Crowe type IV developmental dysplasia of the hip

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

Effects of various load magnitudes on ACL: an in vitro study using adolescent porcine stifle joints

Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis

Assessing ChatGPT’s orthopedic in-service training exam performance and applicability in the field

MiR-98-5p plays suppressive effects on IL-1β-induced chondrocyte injury associated with osteoarthritis by targeting CASP3

Epidemiological investigation and diagnostic analysis of osteonecrosis of the femoral head in three northeastern provinces of China

Biomechanical changes in the proximal femur before and after removal of femoral neck system