An alternative treatment method to restore limb-length discrepancy in osteoarthritis with high congenital hip dislocation.
OBJECTIVE
The purpose of this study was to describe the rationale and to analyse the results of uncemented total hip arthroplasty (THA) in patients with osteoarthritis and congenital dislocation of the hip (CDH) prior to iliofemoral distraction.


METHODS
Twenty hips were followed-up for 5.8 years (1-12 years). First the THA components were implanted after soft tissue release. In the interval, iliofemoral distraction with an external distraction apparatus was conducted. The second surgery consisted of an open reduction. An iliofemoral distraction of 0.8 mm/day was monitored. The treatment time was 86 days (50-210 days). In 61 days (32-94 days) the hip joints were distracted for 51 mm (41-75 mm).


RESULTS
The Harris Hip Score increased significantly by 47 points. The SF-36 health score showed a satisfying increase in all patients.


CONCLUSIONS
In experienced hands this method is a relatively safe procedure for limb-length equalization in patients with severe CDH.
Lerch
Matthias
M
Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany. matthias.lerch@annastift.de
Thorey
F
F
von Lewinski
G
G
Klages
P
P
Wirth
C J
CJ
Windhagen
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000209:etiology; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications*; D006801:Humans; D007870:Leg Length Inequality / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D015207:Osteoarthritis, Hip / Q000150:complications / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects; D057068:Periprosthetic Fractures; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections; D055815:Young Adult