title: [CLINICAL RESULTS OF UNCEMENTED TOTAL HIP ARTHROPLASTY FOR ULTIMATE HIP DISEASE COMBINED WITH PROXIMAL FEMORAL DEFORMITY].
abstract: OBJECTIVE
  To evaluate the clinical results of uncemented total hip arthroplasty (THA) for ultimate hip disease combined with proximal femoral deformity.
  
  
  METHODS
  Between February 2005 and June 2013, 48 cases (51 hips) of ultimate hip disease combined with proximal femoral deformity were treated with uncemented THA and osteotomy. There were 14 males (16 hips) and 34 females (35 hips), with an average age of 52 years (range, 19-83 years). Unilateral hip was involved in 45 cases, and bilateral hips in 3 cases. There were 36 cases (39 hips) of developmental dysplasia of hip, 3 cases (3 hips) of traumatic arthritis, 1 case (1 hip) of previous intertrochanteric valgus osteotomy, 4 cases (4 hips) of internal fixation failure, 3 cases (3 hips) of tuberculosis, and 1 case (1 hip) of suppurative infection. Preoperative Trendelenburg sign was positive in all hips. The discrepancy of limbs was observed in 19 patients. According to Berry classification system, deformity located at the greater trochanter in 4 hips, at the femoral neck in 39 hips, at the femur metaphysis in 7 hips, and at femoral shaft in 1 hip. The Harris score was 34.28 ± 3.28 before operation.
  
  
  RESULTS
  Healing of incision by first intention was obtained in all patients. Deep venous thrombosis occurred in 1 patient, and no complications of infection, neurovascular injury, or prosthetic dislocation were found. Forty-seven patients (50 hips) were followed up 3.8 years on average (range, .1-9 years). At last follow-up, the Harris hip score was 92.87 ± 4.57, showing significant difference when compared to preoperative score (t = -213.19, P = 0.00). Postoperative Trendelenburg sign was positive in 6 hips. Normal gait was shown in 39 cases, and slight limp in 8 cases. X-ray film results showed complete correction of deformity and bony fusion at the osteotomy sites at 3 to 6 months (mean, 4.4 months) after operation. At last follow-up, all the femoral and acetabulum components showed radiographic evidence of bone ingrowth. Osteolysis was observed in Gruen zones 1 and 7 around the femoral prosthesis of 2 cases. There was no case of prosthesis loosening.
  
  
  CONCLUSIONS
  The biological fixation of the femoral stem prosthesis combined with corrective osteotomy can attain satisfactory result for ultimate hip disease combined with proximal femoral deformity in THA.
authors.forename: Zhenjun
authors.initials: Z
authors.lastname: You
authors.forename: Junying
authors.initials: J
authors.lastname: Sun
authors.forename: Guochun
authors.initials: G
authors.lastname: Zha
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Shengjie
authors.initials: S
authors.lastname: Dong
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
mesh_terms: D000077:Acetabulum; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000601:surgery*; D005272:Femur Neck; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D004204:Joint Dislocations; D008297:Male; D008875:Middle Aged; D009139:Musculoskeletal Abnormalities / Q000601:surgery*; D010027:Osteotomy; D011184:Postoperative Period; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome