title: Total hip arthroplasty for Crowe IV hip without subtrochanteric shortening osteotomy -a long term follow up study.
abstract: BACKGROUND
  Several authors reported encouraging results of total hip arthroplasty (THA) for Crowe IV hips performed using shortening osteotomy. However, few papers have documanted the results of THA for Crowe IV hips without shortening osteotomy. The aim of the present study was to assess the long term-results of cemented THAs for Crowe group IV hips performed without subtrochanteric shortening osteotomy.
  
  
  METHODS
  We have assessed the long term results of 27 cemented total hip arthroplasty (THA) performed without subtrochanteric osteotomy for Crowe group IV hip. All THAs were performed via transtrochanteric approach.
  
  
  RESULTS
  After a mean follow-up of 10.6 (6 to 17.9) years, 25 hips (92.6%) had survived without revision surgery and survivorship analysis gave a survival rate of 96.3% at 10 years with any revision surgery as the end point. Although mean limb lengthening was 3.2 (1.0 to 5.1) cm, no hips developed nerve palsy. Complications occurred in four hips, necessitating revision surgery in two. Among the four complications, three involved the greater trochanter, two of which occurred in cases where braided cables had been used to reattach the greater trochanter.
  
  
  CONCLUSIONS
  Although we encountered four complications, including three trochanteric problems, our findings suggest that THA without subtrochanteric shortening osteotomy can provide satisfactory long-term results in patients with Crowe IV hip.
authors.affiliation: Department of Orthopaedic Surgery, Kyoto City Hospital, 1-2, Higashitakada-cho, Mibu, Nakagyo-ku, Kyoto 604-8845, Japan. kawait@kuhp.kyoto-u.ac.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kawai
authors.forename: Chiaki
authors.initials: C
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanoe
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D014182:Transplantation, Autologous