Chang Sun1, Yu Zhang2, Lin Tao Li1, Hao Ding1, Ting Guo1, Jian Ning Zhao3. 1. Department of Orthopedics, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, People's Republic of China. 2. Department of Orthopedics, Jinling Hospital, the first School of Clinical Medicine, Southern Medical University, Nanjing 210002, People's Republic of China. 3. Department of Orthopedics, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, People's Republic of China; Department of Orthopedics, Jinling Hospital, the first School of Clinical Medicine, Southern Medical University, Nanjing 210002, People's Republic of China.
Abstract
BACKGROUND: The reconstruction of high dislocation related to developmental dysplasia of the hip (DDH) remains challenging for joint surgeons. The aim of this study is to evaluate the rate of union, the revision rate, functional scores, and complications in patients with Crowe IV DDH treated with total hip arthroplasty, transverse subtrochanteric shortening osteotomy, and modular stem in an average 10-year follow-up. METHODS: Twenty-eight patients (33 hips) with Crowe IV DDH who were operated on between 2008 and 2013 were followed. All patients underwent uncemented total hip arthroplasty with transverse subtrochanteric shortening osteotomy and anatomical acetabular cup implantation. The mean age was 36.6 years, and the mean follow-up period was 121 months. Clinical and radiological outcomes were evaluated. RESULTS: The mean Harris Hip Score significantly improved from 47.0 preoperatively to 89.6 postoperatively. The mean limb length discrepancy was significantly reduced from 3.8 to 0.8 cm. The mean osteotomy union time was 6.8 months. At the mean follow-up of 121 months, there were 3 cases of postoperative dislocation, 2 cases of intraoperative fracture, and 1 case of posterior tibial venous thrombosis. No revision occurred, and no signs of component loosening or migration were observed at the last follow-up. CONCLUSION: Crowe IV DDH patients treated with transverse subtrochanteric shortening osteotomy, modular stem, and anatomic acetabular component insertion can have satisfactory and reliable 10-year clinical outcomes.
BACKGROUND: The reconstruction of high dislocation related to developmental dysplasia of the hip (DDH) remains challenging for joint surgeons. The aim of this study is to evaluate the rate of union, the revision rate, functional scores, and complications in patients with Crowe IV DDH treated with total hip arthroplasty, transverse subtrochanteric shortening osteotomy, and modular stem in an average 10-year follow-up. METHODS: Twenty-eight patients (33 hips) with Crowe IV DDH who were operated on between 2008 and 2013 were followed. All patients underwent uncemented total hip arthroplasty with transverse subtrochanteric shortening osteotomy and anatomical acetabular cup implantation. The mean age was 36.6 years, and the mean follow-up period was 121 months. Clinical and radiological outcomes were evaluated. RESULTS: The mean Harris Hip Score significantly improved from 47.0 preoperatively to 89.6 postoperatively. The mean limb length discrepancy was significantly reduced from 3.8 to 0.8 cm. The mean osteotomy union time was 6.8 months. At the mean follow-up of 121 months, there were 3 cases of postoperative dislocation, 2 cases of intraoperative fracture, and 1 case of posterior tibial venous thrombosis. No revision occurred, and no signs of component loosening or migration were observed at the last follow-up. CONCLUSION: Crowe IV DDHpatients treated with transverse subtrochanteric shortening osteotomy, modular stem, and anatomic acetabular component insertion can have satisfactory and reliable 10-year clinical outcomes.
Authors: Bjoern Vogt; Christoph Theil; Georg Gosheger; Adrien Frommer; Burkhard Moellenbeck; Gregor Toporowski; Robert Roedl; Andrea Laufer Journal: Int Orthop Date: 2021-06-28 Impact factor: 3.075