title: Surgical hip dislocation according to Ganz for excision of osteochondromas in patients with multiple hereditary exostoses.
abstract: OBJECTIVE
  We report a prospective cohort study of the midterm results of surgical dislocation of the hip (according to Ganz) to perform resection of osteochondromas involving the femoral neck in patients with multiple hereditary exostoses (MHE).
  
  
  METHODS
  Hip range of movement (ROM) was assessed pre- and post-operatively. Patients' judgment of post-operative reduction of pain, symptoms, the Rand 36-item Health Survey (RAND-36) and complications were analysed.
  
  
  RESULTS
  Symptomatic osteochondromas of the femoral neck were removed in 20 hips (17 patients) between 2007 and 2012. There were nine men and eight women with a mean age at the time of surgery of 29 years (11 to 47). Mean follow-up was 46 months (26 to 73). At latest follow-up, mean ROM was significantly increased in all directions. Post-operatively the pain associated with the lesion was either significantly decreased or non-existent. There was a significant improvement in seven RAND-36 sub-domains. Encountered complications in four patients were pseudoarthrosis of the trochanteric osteotomy, traumatic separation of the trochanteric osteotomy, a pertrochanteric femoral fracture and avasvular necrosis. Histological analysis revealed osteochondromas in all hips.
  
  
  CONCLUSIONS
  This study confirms the Ganz trochanteric flip osteotomy provided a reliable approach to osteochondromas of the femoral neck that are otherwise difficult to access for surgical resection. The procedure offered significant improvement in the quality of life, although one should be aware of the serious complications can arise despite the relatively safe procedure.
  
  
  CONCLUSIONS
  When daily function and activities are affected, resection of osteochondromas of the proximal femur according to Ganz is indicated to significantly improve quality of life.
authors: Department of Orthopaedic Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Oosterpark 9, 1090 HM Amsterdam, The Netherlands.
authors: J C
authors: JC
authors: Sorel
authors: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors: M
authors: M
authors: Façee Schaeffer
authors: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors: A S
authors: AS
authors: Homan
authors: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors: V A B
authors: VA
authors: Scholtes
authors: Onze Lieve Vrouwe Gasthuis , Amsterdam, The Netherlands.
authors: D H R
authors: DH
authors: Kempen
authors: Onze Lieve Vrouwe Gasthuis , Amsterdam, The Netherlands.
authors: S J
authors: SJ
authors: Ham
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005097:Exostoses, Multiple Hereditary / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005266:Femoral Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: ganz; multiple hereditary exostoses; osteochondroma; proximal femur; surgical hip dislocation