title: Total hip arthroplasty with subtrochanteric shortening osteotomy for Crowe grade 4 dysplasia using the direct anterior approach.
abstract: Between September 2006 and June 2011, 1521 primary total hip arthroplasties were performed using the direct anterior approach on a standard surgical table. In 12 hips, subtrochanteric shortening osteotomy was required. Full weight bearing was allowed 1 week after surgery. The mean follow-up period was 3.7 years. All patients limped preoperatively, but no patient had a positive Trendelenburg or Duchenne limp at the last follow-up. On the basis of our findings, we believe that the direct anterior approach is a safe and reproducible technique for total hip arthroplasty with subtrochanteric shortening osteotomy in the case of Crowe grade 4 dysplasia. It allows the steady recovery of the abductor muscles, a shorter period to postoperative partial weight bearing, and elimination of limping.
authors.affiliation: Funabashi Orthopedic Hospital, Funabashi City, Chiba, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Oinuma
authors.affiliation: Funabashi Orthopedic Hospital, Funabashi City, Chiba, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tamaki
authors.affiliation: Funabashi Orthopedic Hospital, Funabashi City, Chiba, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Funabashi Orthopedic Hospital, Funabashi City, Chiba, Japan.
authors.forename: Ryutaku
authors.initials: R
authors.lastname: Kaneyama
authors.affiliation: Funabashi Orthopedic Hospital, Funabashi City, Chiba, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shiratsuchi
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D006618:Hip Dislocation, Congenital / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy; D011859:Radiography; D016896:Treatment Outcome
keywords: Trendelenburg limp; crowe grade 4 dysplasia; direct anterior approach; duchenne limp; subtrochanteric shortening osteotomy; total hip arthroplasty