Transverse subtrochanteric shortening osteotomy in primary total hip arthroplasty for patients with severe hip developmental dysplasia.
Twenty-four total hip arthroplasties were performed on patients with Crowe grade 3 or 4 hip dysplasia using subtrochanteric shortening osteotomy with 2 kinds of femoral stems. The average age of the patients was 44.8 years, and their average length of follow-up was 4.7 years. Acetabular reconstruction with structural autograft was used in 11 hips. Radiologically, hip centers were nearly normalized by a vertical height of 10.6-mm elevation and a horizontal length of 1.7 mm as compared with uninvolved sites. Three osteotomy nonunions required revisions with bone graft. One acetabular revision was performed for migration. One postoperative dislocation was managed successfully with closed reduction and an abduction brace. However, no neurologic complication was noticed. The Harris hip score improved from 35.6 to 81.7. A cementless modular distal fluted femoral stem is a useful device in these patients.
Park
Myung-Sik
MS
Department of Orthopedics, Chonbuk National University Hospital and Research Institute of Clinical Medicine, Jeonju, Chonbuk, South Korea.
Kim
Kyu-Hyung
KH
Jeong
Woo-Cheol
WC
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome