title: Large diameter metal-on-metal total hip arthroplasty for Crowe IV developmental dysplasia of the hip.
abstract: The short-term results of middle-aged patients with severe developmental dysplasia of the hip treated with subtrochanteric femoral shortening and cementless large diameter metal-on-metal total hip arthroplasty were retrospectively evaluated. Clinical and radiological results of 15 hips of 13 patients with Crowe IV developmental dysplasia of the hip were enrolled in this study. The average follow-up period was 49 months (36-62 months). The average age of patients at the time of surgery was 45.5 years (range, 36-65 years). Radiographs were evaluated for component position, subsidence, loosening, and osteolysis. Intraoperatively, two patients had a small proximal femoral shaft split that was held with a cable wire. The average preoperative Harris hip score was 58; at 3 years, 82. Trendelenburg sign was negative in 11 hips at the last assessment. Loosening, subsidence, infection, dislocation, hypersensitivity and neurovascular complications were not observed. One hip had to be revised 1 year after surgery because of nonunion at the osteotomy site. Our study shows that large diameter metal-on-metal total hip arthroplasty, incorporating subtrochanteric femoral shortening, decreases dislocation rate and provides excellent results for the completely dislocated hip.
authors.affiliation: Taksim Training and Research Hospital, Orthopedics and Traumatology Department, Istanbul, Turkey.
authors.forename: Atilla Sancar
authors.initials: AS
authors.lastname: Parmaksizoglu
authors.forename: Ufuk
authors.initials: U
authors.lastname: Ozkaya
authors.forename: Fuat
authors.initials: F
authors.lastname: Bilgili
authors.forename: Seckin
authors.initials: S
authors.lastname: Basilgan
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Kabukcuoglu
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index