title: Total hip arthroplasty with femoral subtrochanteric osteotomy after Schanz osteotomy.
abstract: BACKGROUND
  Schanz osteotomy is one of the options for the management of hip instability caused by congenital or septic arthritis. Following Schanz osteotomy, there is risk of hip pain secondary to hip arthritis. It may be necessary to perform subtrochanteric femoral osteotomy in conjunction with total hip arthroplasty (THA). This study evaluates the outcomes and complications associated with THA.
  
  
  METHODS
  We performed 36 THA after Schanz osteotomy. Patients were divided into three groups: (1) successful Schanz osteotomy, (2) highly dislocated hip with contact between the femoral head and pelvis, and (3) completely dislocated hip without contact between the femur and pelvis. Clinical and radiological evaluations were completed for each group.
  
  
  RESULTS
  In all three groups, hip function improved significantly (p < 0.01). There were four types of complications: transient paralysis, femoral fracture, dislocation, and non-union. Complications occurred frequently in the completely dislocated hip group.
  
  
  CONCLUSIONS
  Our study shows that acceptable results may be obtained from THA with subtrochanteric femoral osteotomy after Schanz osteotomy. However, this procedure is a technically demanding treatment option, and there were characteristic complications intra and after surgery. Therefore, surgeons should treat hip osteoarthritis after Schanz operation with utmost care, especially completely dislocated hip.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan. Electronic address: epc9719@yahoo.co.jp.
authors.forename: Motoki
authors.initials: M
authors.lastname: Sonohata
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kawano
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan.
authors.forename: Riki
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, 849-8501, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mawatari
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery*; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D012086:Reoperation; D016896:Treatment Outcome