Subtrochanteric corrective osteotomy for the endoprosthetic treatment of high hip dislocation. Treatment and mid-term results with a cementless straight stem.

Total hip arthroplasty is problematical in the case of high dislocation. To reposition the hip, a femoral shortening osteotomy is necessary in order to prevent damage to the neurovascular structures. This paper describes the implantation of a cementless straight stem in 15 patients using a simple technique with a simultaneous, derotating and shortening osteotomy. Femur fractures, pseudoarthroses, stem loosening, paresis and deep infections were not found. One socket loosening was revised. Fourteen patients had good or very good results in the Merle d'Aubigne score after a median of 4.3 (range 2-5.6) years of follow-up. The surgical technique described enables the initial stable fixation of a standard prosthesis without additional osteosynthesis. Additional advantages include a shorter duration of surgery, a lower complication rate and a more rapid consolidation of the osteotomy.