Published in:
01-07-2012 | Original Article
Total hip arthroplasty combined with double-chevron subtrochanteric osteotomy
Published in: Journal of Orthopaedic Science | Issue 4/2012
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Background
Subtrochanteric femoral shortening and corrective osteotomy are regarded as an integral part of total hip arthroplasty for a completely dislocated hip or severe deformity of the proximal femur. Alternative femoral osteotomy techniques—transverse, oblique, step-cut, and V-shaped, have been described.
Methods
In this series, we performed 22 cementless total hip arthroplasties combined with double-chevron subtrochanteric osteotomies between 1997 and 2002. There were 17 females and 2 males. Their average age at the time of the operation was 59 years (range 41–74 years). Thirteen hips were completely dislocated, 8 hips needed treatment after a proximal femoral osteotomy, and there was 1 case of hip ankylosis.
Results
The mean length of the operation was 128 min (range 80–215 min). Mean total blood loss was 1442 g (range 809–2007 g), which included both the intraoperative blood loss and postoperative blood loss. After an average of 7.6 years of follow-up, the Japanese Orthopaedic Association Hip Score improved from 48 to 79. Three types of complication were observed. There were 4 early dislocations, 3 proximal splits, and 1 nonunion at the osteotomy site.
Conclusions
Our study shows that acceptable results are obtained from double-chevron subtrochanteric osteotomy for subtrochanteric femoral shortening and corrective osteotomy. However, total hip arthroplasty combined with subtrochanteric osteotomy is a technically demanding treatment option.