Abstract
Background
We aimed to present our THA technique without femoral shortening osteotomy that we perform for the treatment of coxarthrosis on Crowe type III/IV developmental dysplasia of the hip and to present the early clinical outcomes of our patients.
Methods
77 patients with Crowe type III/IV developmental dysplasia of the hip, who had admitted to our clinic between 2013 and 2017, and had undergone cementless THA without femoral shortening by a single surgeon, were retrospectively evaluated. Patients were called for a final evaluation and assessed by Harris Hip Score. Trendelenburg sign was observed. For radiological evaluation, routine anteroposterior and lateral hip radiography and orthoroentgenogram was used.
Results
Mean duration of follow-up was 38.2 (22–52) months. Pre-operative mean Harris Hip Score was 53.9 (49–62) and post-operative mean value was 82.7 (76–95). Mean duration of operation was 44.9 (39–57) min. In post-operative final evaluation only three patients (3.8%) had positive Trendelenburg sign. 3 patients (3.8%) had early dislocation. No sciatic palsy was observed in any of the patients. Revision with acetabular cage was performed for one (1.2%) patient due to protrusion development in the acetabular cup. The mean prosthesis survival rate was 98.8%.
Conclusions
Total hip arthroplasty without femoral osteotomy can be considered as a successful method in selected patients with Crowe III/IV coxarthrosis. It provides good clinical outcomes in the early period, reduces surgery duration, has acceptable complication rates, has high prosthesis survival rates.
Similar content being viewed by others
References
Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ (2010) Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia: surgical technique. J Bone Joint Surg Am 92(2):176–187
Engesaeter L, Furnes O, Havelin L (2008) Developmental dysplasia of the hip-good results of later total hip arthroplasty: 7135 primary total hip arthroplasties after developmental dysplasia of the hip compared with 59774 total hip arthroplasties in idiopathic coxartrhosis followed for 0 to 15 years in the Norwegian Artrhoplasties Register. J Arthroplast 23:235–240
Pagnano W, Hanssen AD, Lewallen DG, Shaughnessy WJ (1996) The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am 78:1004–1014
Lai KA, Shen WJ, Huang LW, Chen MY (2005) Cementless total hip arthroplasty and limb-length equalization in patients with unilateral Crowe type-IV hip dislocation. J Bone Joint Surg Am 87:339–345
Sofu H, Kockara N, Gursu S, Issin A, Oner A, Sahin V (2015) Transverse subtrochanteric shortening osteotomy during cementless total hip arthroplasty in Crowe type-III or IV developmental dysplasia. J Arthroplast 30:1019–1023
Bao N, Meng J, Zhou L, Guo T, Zeng X, Zhao J (2013) Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip. Int Orthop 37:385–390
Ahmed E, Ibrahime G, Ayman B (2015) Total hip arthroplasty with subtrochanteric osteotomy in neglected dysplastic hip. Int Orthop 39:27–33
Koulouvaris P, Stafylas K, Sculco T, Xenakis T (2008) Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction: a new surgical technique. J Arthroplast 23:992–998
Takao M, Ohzono K, Nishii T, Miki H, Nakamura N, Sugano N (2011) Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental hip dysplasia. J Bone Joint Surg Am 93:548–555
Neumann DR, Dorn U (2007) Total hip replacement in high total hip dislocation by performing a Z-shaped shortening osteotomy. Z Orthop Ihre Grenzgeb 145:68–73
Park MS, Kim KH, Jeong WC (2007) Transverse subtrochanteric shortening osteotomy in primary total hip arthroplasty for patients with severe hip developmental dysplasia. J Arthroplast 22:1031–1036
Howie CR, Ohly NE, Miller B (2010) Cemented total hip arthroplasty with subtrochanteric osteotomy in dysplastic hips. Clin Orthop Relat Res 468:3240–3247
Becker DA, Gustilo RB (1995) Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplast 10:313–318
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An endresult study using a new method of result evaluation. J Bone J Surg Am 51:737–755
Isik C, Apaydin N, Acar HI, Zahar A, Bozkurt M (2014) The gluteal sling an anatomical study. Surg Raidol Anat 36:595–599
Leonardsson O, Rolfson O, Rogmark C (2016) The surgical approach for hemiarthroplasty does not influence patient-reported outcome: a national survey of 2118 patients with one-year follow-up. Bone Joint J 98-B:542–547
Maratt JD, Gagnier JJ, Butler PD, Hallstrom BR, Urquart AG, Roberts KC (2016) No difference in dislocation seen in anterior vs posterior approach total hip arthroplasty. J Arthroplast 31:127–130
Wang L, Trousdale RT, Ai S, An KN, Dai K, Morrey BF (2012) Dislocation after total hip arthroplasty among patients with developmental dysplasia of the hip. J Arthroplast 27:764–769
Kwon MS, Kuskowski M, Mulhall KJ, Macaulay W, Brown TE, Saleh KJ (2006) Does surgical approach affect total hip arthroplasty dislocation rates? Clin Orthop Relat Res 447:34–38
Chiu FY, Chen C, Chung T, Lo WH, Chen TH (2000) The effect of posterior capsulorrhaphy in primary total hip arthroplasty: a prospective randomized study. J Arthroplast 15:194–199
Khan T, Knowles D (2007) Damage to the superior gluteal nerve during the direct lateral approach to the hip: a cadaveric study. J Arthroplast 22:1198–1200
Fox AJ, Bedi A, Wanivenhaus F, Sculco TP, Fox JS (2012) Femoral neuropathy following total hip arthroplasty: review and management guidelines. Acta Orthop Belg 78:145–151
Kim MD, Toru Kadowaki MD (2010) High long-term survival of bulk femoral head autograft for acetabular reconstruction in cementless THA for developmental hip dysplasia. Clin Orthop Relat Res 468:1611–1620
Abdel MP, Stryker LS, Trousdale RT, Berry DJ, Cabanela ME (2014) Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years. J Bone Joint Surg Am 96:1878–1882
Mulroy RD Jr, Harris WH (1990) Failure of acetabular autogenous grafts in total hip arthroplasty. Increasing incidence: a follow-up note. J Bone Joint Surg Am 72:1536–1540
Rodriguez JA, Huk OL, Pellicci PM, Wilson PD Jr (1995) Autogenous bone grafts from the femoral head for the treatment of acetabular deficiency in primary total hip arthroplasty with cement: long-term results. J Bone Joint Surg Am 77:1227–1233
Bicanic G, Delimar D, Delimar M, Pecina M (2009) Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop 33:397–402
Götze C, Winkelmann W, Gosheger G, Rödl R (2007) Is there a need of an additional extramedullary fixation in transverse subtrochanteric shortening in primary total hip arthroplasty for patients with severe hip dysplasia? Short-term experience in seven patients with congenital dislocation. Z Orthop Unfallchir 145:568–573
Çatma MF, Ünlü S, Öztürk A, Aksekili AM, Ersan Ö, Ateş Y (2016) Femoral shortening osteotomy in total hip arthroplasty for severe dysplasia: a comparison of two fixation techniques. Int Orthop 40:2271–2276
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Tahta, M., Isik, C., Uluyardimci, E. et al. Total hip arthroplasty without subtrochanteric femoral osteotomy is possible in patients with Crowe III/IV developmental dysplasia: total hip arthroplasty without femoral osteotomy. Arch Orthop Trauma Surg 140, 409–413 (2020). https://doi.org/10.1007/s00402-019-03320-6
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-019-03320-6