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International Orthopaedics

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01-09-2015 | Original Paper

Oblique femoral shortening osteotomy in total hip arthroplasty for high dislocation in patients with hip dysplasia

Authors: Luigi Zagra, Luca Bianchi, Andrea Mondini, Roberto Giacometti Ceroni

Published in: International Orthopaedics | Issue 9/2015

Abstract

Purpose

The aim of this study was to evaluate outcomes after implantation of total hip arthroplasty for developmental dysplasia with high dislocation of the hip using conical stems combined with oblique subtrochanteric shortening osteotomy.

Methods

We retrospectively reviewed the functional scores, radiographic results, and complications in a consecutive series of 16 hips (12 patients) with Crowe IV developmental dysplasia of the hip. The average age at surgery was 53.2 years and the patients were operated on between 1999 and 2008.

Results

The average Harris Hip Score improved from 37.2 to 83.7 at a mean follow-up of 8.7 years. All acetabular cups were inserted into the true acetabulum and all prosthetic components were stable at the last follow-up visit. No neurovascular damage was recorded. Complications arose in six hips (37.5 %): intra-operative fracture of proximal femur requiring fixation (n = 2); dislocation (n = 3); and asymptomatic non-union of the osteotomy (n = 1). The osteotomy healed within less than six months in all the remaining cases.

Conclusions

With the numbers given the oblique femur shortening osteotomy led to an increased rotational stability and proved to be a simple and effective method. Compared with transverse osteotomy and as related to our experience, this technique may be a method of choice in selected cases.

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 Artroplasties Register. J Arthroplasty 23:235–240CrossRefPubMed

Erdemli B, Yilmaz C, Atalar H, Guzel B, Cetin L (2005) Total hip arthroplasty in developmental high dislocation of the hip. J Arthroplasty 20(8):1021–1028CrossRefPubMed

Pagnano MW, 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(7):1004–1014PubMed

Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15PubMed

Cameron HU, Eren OT, Solomon M (1998) Nerve injury in the prosthetic management of the dysplastic hip. Orthopedics 21:980PubMed

Edwards BN, Tullos HS, Noble PC (1987) Contributory factors and aetiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop 218:136–141PubMed

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

Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ (2009) Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia. J Bone Joint Surg Am 91:2213–2221CrossRefPubMed

Eskelinen A, Helenius I, Remes V, Ylinen P, Tallroth K, Paavilainen T (2006) Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone Joint Surg Am 88(1):80–91CrossRefPubMed

10.

Hartofilakidis G, Karachalios T (2004) Total hip arthroplasty for congenital hip disease. J Bone Joint Surg Am 86:242–250PubMed

11.

Park MS, Kim KH, Jeong WC (2007) Transverse subtrochanteric shortening osteotomy in primary total hip arthroplasty for patients with severe hip developmental dysplasia. J Arthroplasty 22:1031–1036CrossRefPubMed

12.

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 37:385–390PubMedCentralCrossRefPubMed

13.

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

14.

Makita H, Inaba Y, Hirakawa K, Saito T (2007) Results on total hip arthroplasties with femoral shortening for Crowe’s group IV dislocated hips. J Arthroplasty 22(1):32–38CrossRefPubMed

15.

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 Arthroplasty 23:992–998CrossRefPubMed

16.

Decking J, Decking R, Schoellner C et al (2003) Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip. Arch Orthop Trauma Surg 123:356–362CrossRef

17.

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(6):548–555CrossRefPubMed

18.

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(1):68–73CrossRefPubMed

19.

Howie CR, Ohly NE, Miller B (2010) Cemented total hip arthroplasty with subtrochanteric osteotomy in dysplastic hips. Clin Orthop Relat Res 468:3240–3247PubMedCentralCrossRefPubMed

20.

Yasgur DJ, Stuchin SA, Adler EM, DiCesare PE (1997) Subtrochanteric shortening osteotomy in total hip arthroplasty for high-riding developmental dislocation of the hip. J Arthroplasty 12:880–888CrossRefPubMed

21.

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 Arthroplasty 10:313–318CrossRefPubMed

22.

Hotokebuchi T, Sonohata M, Shigematsu M et al (2006) A new device for a v-shaped subtrochanteric osteotomy combined with total hip arthroplasty. J Arthroplasty 21:135CrossRefPubMed

23.

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

24.

Kiliçoģlu O, Türker M, Akgül T, Yazicioģlu O (2013) Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation. J Arthroplasty 28:117–125CrossRefPubMed

25.

Paavilainen T, Hoikka V, Solonen KA (1990) Cementless total replacement for severly dysplastic or dislocated hips. J Bone Joint Surg (Br) 72:205

26.

Nagoya S, Kaya M, Sasaki M et al (2009) Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip. J Bone Joint Surg (Br) 91-B:1142–1147CrossRef

27.

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

28.

DeLee J, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32PubMed

29.

Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141:17PubMed

30.

Wagner H, Wagner M (2000) Cone prosthesis for the hip joint. Arch Orthop Trauma Surg 120:88–95PubMed

31.

Faldini C, Nanni M, Leonetti D, Miscione MT, Acri F, Giannini S (2011) Total hip arthroplasty in developmental hip dysplasia using cementless tapered stem. Results after a minimum 10-years follow-up. Hip Int 21:415–420CrossRefPubMed

32.

Benazzo F, Cuzzocrea F, Stroppa S, Ravasi F, Dalla Pria P (2007) Modular stems in DDH. Hip Int 17(Suppl 5):S138–S141PubMed

33.

Bruce WJ, Rizkallah SM, Kwon YM, Golberg JA, Walsh WR (2000) A new technique of sub-trochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. J Arthroplasty 15:617–626CrossRefPubMed

34.

Kim YH, Seo HS, Kim JS (2009) Outcomes after THA in patients with high hip dislocations after childhood sepsis. Clin Orthop Relat Res 467:2371–2378PubMedCentralCrossRefPubMed

35.

Chareancholvanich K, Becker D, Gustilo R (1999) Treatment of congenital dislocated hip by arthroplasty with femoral shortening. Clin Orthop Relat Res 360:127–135CrossRefPubMed

36.

Masonis JL, Patel JV, Miu A, Bourne RB, McCalden R, Macdonald SJ, Rorabeck CH (2003) Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe dysplasia: 5-year follow-up. J Arthroplasty 18:68–73CrossRefPubMed

Title: Oblique femoral shortening osteotomy in total hip arthroplasty for high dislocation in patients with hip dysplasia
Authors: Luigi Zagra
Luca Bianchi
Andrea Mondini
Roberto Giacometti Ceroni
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2865-9

At a glance: The STEP trials

Springer Medicine

Oblique femoral shortening osteotomy in total hip arthroplasty for high dislocation in patients with hip dysplasia

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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