Evaluation of the modified Albee arthroplasty for femoral head loss secondary to septic arthritis in young children.
BACKGROUND
Surgical treatment options for femoral head deficiency in infants secondary to septic arthritis of the hip are varied and associated with uncertain long-term outcomes. The modified Albee arthroplasty has been considered an acceptable procedure; however, the long-term outcomes of this procedure have not been reported, to our knowledge. We evaluated the long-term outcomes of the modified Albee arthroplasty in young patients with severe sequelae of septic arthritis of the hip.


METHODS
We retrospectively studied twenty-one children (twenty-one hips) in whom Choi type-IVB sequelae of septic arthritis of the hip had been treated with a modified Albee arthroplasty and six patients with the same sequelae who had been managed with simple observation. The Trendelenburg sign, pain, the range of motion, hip function, the Harris hip score, and limb-length discrepancy were assessed clinically. Remodeling of the femoral head, hip stability, and arthritic changes in the hip were evaluated radiographically.


RESULTS
The twenty-one patients with the modified Albee arthroplasty were followed for an average of 121.2 +/- 38.6 months and had better outcomes, in terms of the Trendelenburg sign, the Harris hip score, pain, the hip range of motion, and limb-length discrepancy, than the six patients who underwent simple observation. Patients who were two years of age or younger at the time of the arthroplasty exhibited a significantly less severe limb-length discrepancy and less loss of motion than those who were older than two at the time of the surgery. Furthermore, limb-length discrepancy was positively correlated and the range of motion of the hip and the Harris hip scores were negatively correlated with the patient's age at the time of the surgery, suggesting that early surgery in patients with severe sequelae of septic arthritis of the hip is associated with a better clinical outcome.


CONCLUSIONS
The modified Albee arthroplasty is a feasible and clinically useful procedure for the treatment of severe sequelae of septic arthritis of the hip, particularly in children who are two years of age or younger.
Li
Xue-dong
XD
Department of Orthopaedics, the 1st Affiliated Hospital, Medical College of Shantou University, Guangdong 515041, China.
Chen
Bin
B
Fan
Jun
J
Zheng
Chuang-yi
CY
Liu
Dong-xin
DX
Wang
Hu
H
Xia
Xue
X
Ji
Shi-jun
SJ
Du
Shi-xin
SX
D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000150:complications / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007870:Leg Length Inequality / Q000601:surgery; D008297:Male; D010027:Osteotomy; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult