Motoki Sonohata1, Masaru Kitajima2, Shunsuke Kawano2, Riki Tanaka2, Masaaki Mawatari2. 1. Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan. Electronic address: epc9719@yahoo.co.jp. 2. Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan.
Abstract
BACKGROUND: Schanz osteotomy is one of the options for the management of hip instability caused by congenital or septic arthritis. Following Schanz osteotomy, there is risk of hip pain secondary to hip arthritis. It may be necessary to perform subtrochanteric femoral osteotomy in conjunction with total hip arthroplasty (THA). This study evaluates the outcomes and complications associated with THA. METHODS: We performed 36 THA after Schanz osteotomy. Patients were divided into three groups: (1) successful Schanz osteotomy, (2) highly dislocated hip with contact between the femoral head and pelvis, and (3) completely dislocated hip without contact between the femur and pelvis. Clinical and radiological evaluations were completed for each group. RESULTS: In all three groups, hip function improved significantly (p < 0.01). There were four types of complications: transient paralysis, femoral fracture, dislocation, and non-union. Complications occurred frequently in the completely dislocated hip group. CONCLUSIONS: Our study shows that acceptable results may be obtained from THA with subtrochanteric femoral osteotomy after Schanz osteotomy. However, this procedure is a technically demanding treatment option, and there were characteristic complications intra and after surgery. Therefore, surgeons should treat hip osteoarthritis after Schanz operation with utmost care, especially completely dislocated hip.
BACKGROUND: Schanz osteotomy is one of the options for the management of hip instability caused by congenital or septic arthritis. Following Schanz osteotomy, there is risk of hip pain secondary to hip arthritis. It may be necessary to perform subtrochanteric femoral osteotomy in conjunction with total hip arthroplasty (THA). This study evaluates the outcomes and complications associated with THA. METHODS: We performed 36 THA after Schanz osteotomy. Patients were divided into three groups: (1) successful Schanz osteotomy, (2) highly dislocated hip with contact between the femoral head and pelvis, and (3) completely dislocated hip without contact between the femur and pelvis. Clinical and radiological evaluations were completed for each group. RESULTS: In all three groups, hip function improved significantly (p < 0.01). There were four types of complications: transient paralysis, femoral fracture, dislocation, and non-union. Complications occurred frequently in the completely dislocated hip group. CONCLUSIONS: Our study shows that acceptable results may be obtained from THA with subtrochanteric femoral osteotomy after Schanz osteotomy. However, this procedure is a technically demanding treatment option, and there were characteristic complications intra and after surgery. Therefore, surgeons should treat hip osteoarthritis after Schanz operation with utmost care, especially completely dislocated hip.
Authors: Jan Kubicek; Filip Tomanec; Martin Cerny; Dominik Vilimek; Martina Kalova; David Oczka Journal: Sensors (Basel) Date: 2019-11-27 Impact factor: 3.576