title: Total hip arthroplasty with a non-modular conical stem and transverse subtrochanteric osteotomy in treatment of high dislocated hips.
abstract: Conventional stems may be unsuitable for hypoplastic femurs associated with severe dysplasia, meanwhile, custom-made or modular stems in total hip arthroplasty are often complex and expensive. This series included 21 Crowe type IV dysplastic hips in which a non-modular cementless conical stem was implanted with transverse subtrochanteric femoral osteotomy. Follow up averaged 40months. Twenty hips survived with mean Harris hip score improved from 52 to 90. One hip failed for stem loosening. The average leg lengthening was 3.8cm with transient sciatic nerve palsy occurring in three hips. Femoral offset averaged 3.3cm postoperatively. The non-modular conical stem not only obviated the complexities, high medical cost and potential risk at the neck-stem interface associated with stem modularity, but also simplified surgical technique.
authors.affiliation: Department of Orthopaedics, Xinhua Hospital, Affiliated to Shanghai Jiaotong University Medical School, Shanghai China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedics, Xinhua Hospital, Affiliated to Shanghai Jiaotong University Medical School, Shanghai China.
authors.forename: Chao
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Orthopaedics, Xinhua Hospital, Affiliated to Shanghai Jiaotong University Medical School, Shanghai China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Xinhua Hospital, Affiliated to Shanghai Jiaotong University Medical School, Shanghai China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Orthopaedics, Xinhua Hospital, Affiliated to Shanghai Jiaotong University Medical School, Shanghai China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Orthopaedics, Xinhua Hospital, Affiliated to Shanghai Jiaotong University Medical School, Shanghai China.
authors.forename: Guiquan
authors.initials: G
authors.lastname: Cai
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D006615:Hip / Q000601:surgery*; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D057234:Preoperative Period; D011474:Prosthesis Design; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Crowe type IV; cementless stem; high dislocation; subtrochanteric femoral osteotomy; total hip arthroplasty