Cemented total hip arthroplasty with subtrochanteric osteotomy in dysplastic hips.
BACKGROUND
Total hip arthroplasty (THA) in the presence of developmental dysplasia of the hip (DDH) can be technically challenging. Restoring the anatomic center of hip rotation may require femoral osteotomy. Techniques using cementless components are widely reported but less is known about using cemented components that may be more appropriate with osteopenic bone.


OBJECTIVE
We therefore determined the rate of union, complications, and early functional score in a series of patients with DDH who underwent cemented THA and simultaneous subtrochanteric osteotomy.


METHODS
We retrospectively reviewed 28 patients (35 hips) who underwent a cemented THA for DDH at a mean age of 47.3 years. Two patients (two hips) died within 12 months of surgery of unrelated conditions. The clinical notes and radiographs were reviewed with a minimum followup of 2 years (mean, 5.6 years; range, 2-14 years). Complications were noted. SF-12 and Oxford hip scores (OHS) were recorded for 18 patients preoperatively and after 6 and 12 months.


RESULTS
Union occurred in 32 of 33 femora (97%); one patient had an infected nonunion. The overall revision rate was 20% (9% femoral revision rate). There were three dislocations, two of which had further surgery. Two patients had a transient neuropraxia. The mean SF-12 physical component score increased from 32 to 52 and mean SF-12 mental component score increased from 48 to 51. The mean OHS decreased from 40 to 27.


CONCLUSIONS
Combined subtrochanteric osteotomy and cemented THA is technically demanding with a higher complication rate than routine THA. The rate of union, complications, implant survival, and early OHS were comparable to those for similar techniques using cementless components.
Howie
Colin R
CR
Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK. colin.howie@luht.scot.nhs.uk
Ohly
Nicholas E
NE
Miller
Ben
B
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000401:mortality; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000401:mortality; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012606:Scotland; D013997:Time Factors; D016896:Treatment Outcome
D001843:Bone Cements
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