Top

Journal of Orthopaedics and Traumatology

Published in:

Open Access 01-12-2017 | Original Article

Subtrochanteric femoral shortening osteotomy combined with cementless total hip replacement for Crowe type IV developmental dysplasia: a retrospective study

Authors: Giuseppe Rollo, Giuseppe Solarino, Giovanni Vicenti, Girolamo Picca, Massimiliano Carrozzo, Biagio Moretti

Published in: Journal of Orthopaedics and Traumatology | Issue 4/2017

ABSTRACT

Background

Total hip replacement for high dislocation of the hip presents some difficulties, considering patients’ young ages, the abnormal hip anatomy and the high rate of complications. In this study, we present our experience in terms of clinical and radiological results in the treatment of Crowe type IV hips with subtrochanteric femoral shortening osteotomy and cementless total hip replacement.

Materials and Methods

We retrospectively reviewed 15 patients with Crowe type IV hip dysplasia (two bilateral cases for a total of 17 hips) treated with cementless total hip replacement associated with shortening subtrochanteric osteotomies (nine transversal and eight Z-shape osteotomies) between March 2000 to February 2006. The mean follow-up was 88 months (range 63–133). Harris hip score, leg length discrepancy, neurological status, union status of the osteotomy and the component stability were the criteria of the evaluation. All complications were noted.

Results

The mean HHS improved from 38.3 (range 32–52) to 85.6 (range 69–90). The mean preoperative leg length discrepancy was of 45 mm (range 38–70) and reduced to a mean of 12 mm (range 9–1.6) postoperatively. All osteotomies resulted healed at an average of 12.3 weeks (range 10–15). No cases of delayed union or nonunion were detected. Two patients (11%) showed early symptoms of sciatic nerve palsy which resolved uneventfully in 6 months. There was no migrations and none of the implants required revision.

Conclusions

Cementless THA with shortening subtrochanteric osteotomy is an effective method in the treatment of patients with Crowe type IV development dysplasia of the hip.

Level of evidence

IV.

Rosenstein AD, Diaz RJ (2011) Challenges and solutions for total hip arthroplasty in treatment of patients with symptomatic sequelae of developmental dysplasia of the hip. Am J Orthop 40:87–91PubMed

Yang S, Cui Q (2012) Total hip arthroplasty in developmental dysplasia of the hip: review of anatomy, techniques and outcomes. World J Orthop 3:42–48CrossRefPubMedPubMedCentral

Engesaeter LB, Furnes O, Havelin LI (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 coxarthrosis followed for 0 to 15 years. J Arthroplast 23:235–240CrossRef

Gustke K (2013) The dysplastic hip: not for the shallow surgeon. Bone Jt J 95B:31–36CrossRef

Lewallen DG (1998) Neurovascular injury associated with hip arthroplasty. Instr Course Lect 47:275–283PubMed

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 Jt Surg Am 87:339–345CrossRef

Nagoya S, Kaya M, Sasaki M, Tateda K, Kosukegawa I, Yamashita T (2009) Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip. J Bone Jt Surg Br 91:1142–1147CrossRef

Tamegai H, Otani T, Fujii H, Kawaguchi Y, Hayama T, Marumo K (2013) A modified S-ROM stem in primary total hip arthroplasty for developmental dysplasia of the hip. J Arthroplast 28:1741–1745CrossRef

Morscher E (1995) Total hip replacement for osteoarthritis in congenital hip dysplasia. European Federation of National Associations of Orthopaedics and Traumatology 1–8

10.

Russotti GM, Harris WH (1991) Proximal placement of the acetabular component in total hip arthroplasty. A long-term follow-up study. J Bone Jt Surg Am 73:587–592CrossRef

11.

Kaneuji A, Sugimori T, Ichiseki T, Yamada K, Fukui K, Matsumoto T (2009) Minimum 10-year results of a porous acetabular component for Crowe I to III hip dysplasia using an elevated hip center. J Arthroplast 24:187–194CrossRef

12.

Sener N, Tözün IR, Aşik M (2002) Femoral shortening and cementless arthroplasty in high congenital dislocation of the hip. J Arthroplast 17:41–48

13.

Bicanic G, Barbaric K, Bohacek I, Aljinovic A, Delimar D (2014) Current concept in dysplastic hip arthroplasty: techniques for acetabular and femoral reconstruction. World J Orthop 5:412–424CrossRefPubMedPubMedCentral

14.

Yoon PW, Kim J II, Kim DO et al (2013) 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 5:167–173CrossRefPubMedPubMedCentral

15.

Paavilainen T, Hoikka V, Solonen KA (1990) Cementless total replacement for severely dysplastic or dislocated hips. J Bone Jt Surg Br 72:205–211CrossRef

16.

Oe K, Iida H, Nakamura T, Okamoto N, Wada T (2013) Subtrochanteric shortening osteotomy combined with cemented total hip arthroplasty for Crowe group IV hips. Arch Orthop Trauma Surg 133:1763–1770CrossRefPubMedPubMedCentral

17.

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 22:1031–1036CrossRef

18.

Oinuma K, Tamaki T, Miura Y, Kaneyama R, Shiratsuchi H (2013) Total hip arthroplasty with subtrochanteric shortening osteotomy for Crowe grade 4 dysplasia using the direct anterior approach. J Arthroplast 29:626–629CrossRef

19.

Reikerås O, Haaland JE, Lereim P (2010) Femoral shortening in total hip arthroplasty for high developmental dysplasia of the hip. Clin Orthop Relat Res 468:1949–1955CrossRefPubMedPubMedCentral

20.

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 10:313–318CrossRef

21.

Sonohata M, Tajima T, Kitajima M, Ogawa K, Kawano S, Mawatari M, Hotokebuchi T (2012) Total hip arthroplasty combined with double-chevron subtrochanteric osteotomy. J Orthop Sci 17:382–389CrossRefPubMed

22.

Dallari D, Pignatti G, Stagni C, Giavaresi G, Del Piccolo N, Rani N, Veronesi F, Fini M (2011) Total hip arthroplasty with shortening osteotomy in congenital major hip dislocation sequelae. Orthopedics 34:328–333

23.

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 dysplasia. J Bone Jt Surg Am 93:548–555CrossRef

24.

Hasegawa Y, Iwase T, Kanoh T, Seki T, Matsuoka A (2012) Total hip arthroplasty for Crowe type IV developmental dysplasia. J Arthroplast 27:1629–1635CrossRef

25.

Muratli KS, Karatosun V, Uzun B, Celik S (2013) Subtrochanteric shortening in total hip arthroplasty: biomechanical comparison of four techniques. J Arthroplast 29:836–842CrossRef

26.

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 Jt Surg Am 92:176–187CrossRef

27.

Eggli S, Hankemayer S, Müller ME (1999) Nerve palsy after leg lengthening in total replacement arthroplasty for developmental dysplasia of the hip. J Bone Jt Surg Br 81:843–845CrossRef

28.

Papachristou G, Hatzigrigoris P, Panousis K, Plessas S, Sourlas J, Levidiotis C, Chronopoulos E (2006) Total hip arthroplasty for developmental hip dysplasia. Int Orthop 30:21–25CrossRefPubMed

29.

Yalcin N, Kilicarslan K, Karatas F, Mutlu T, Yildirim H (2010) Cementless total hip arthroplasty with subtrochanteric transverse shortening osteotomy for severely dysplastic or dislocated hips. Hip Int 20:87–93CrossRefPubMed

Title: Subtrochanteric femoral shortening osteotomy combined with cementless total hip replacement for Crowe type IV developmental dysplasia: a retrospective study
Authors: Giuseppe Rollo
Giuseppe Solarino
Giovanni Vicenti
Girolamo Picca
Massimiliano Carrozzo
Biagio Moretti
Publication date: 01-12-2017
Publisher: Springer International Publishing
Published in: Journal of Orthopaedics and Traumatology / Issue 4/2017
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI: https://doi.org/10.1007/s10195-017-0466-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Subtrochanteric femoral shortening osteotomy combined with cementless total hip replacement for Crowe type IV developmental dysplasia: a retrospective study

ABSTRACT

Background

Materials and Methods

Results

Conclusions

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

ABSTRACT

Background

Materials and Methods

Results

Conclusions

Level of evidence

Please log in to get access to this content

Other articles of this Issue 4/2017

Management of chronic unstable acromioclavicular joint injuries

Hidden and overall haemorrhage following minimally invasive and open transforaminal lumbar interbody fusion

Cross-cultural adaptation and validation of the Italian version of the Kerlan–Jobe Orthopaedic Clinic Shoulder and Elbow score

A prospective randomized study in 20 patients undergoing bilateral TKA comparing midline incision to anterolateral incision

Cam morphology and inguinal pathologies: is there a possible connection?

Functional and quality of life outcome after non-operatively managed proximal humeral fractures