title: Comparison of Total Hip Arthroplasty With and Without Femoral Shortening Osteotomy for Unilateral Mild to Moderate High Hip Dislocation.
abstract: This study compares the outcome between THA with and without femoral shortening osteotomy for unilateral mild to moderate high hip dislocation in developmental dysplasia of the hip patients.
  
  
  
  The data on 42 hips in 42 patients who had undergone THA for unilateral mild to moderate high hip dislocation were retrospectively reviewed after being prospectively collected. In 22 patients, hips were reduced by soft tissue release and direct leverage using an elevator, without the osteotomy. The remaining 20 patients were treated with a subtrochanteric transverse shortening osteotomy. The mean follow-up of patients was 5 years (standard deviation = 1.0) for the nonosteotomy group and 6.2 years (standard deviation = 1.6) for the osteotomy group.
  
  
  
  The Harris Hip Score significantly improved in both groups. In the nonosteotomy group, we observed a lower leg length discrepancy compared with the osteotomy group (0.4 cm and 2.2 cm, respectively). Four patients (18.2%) in the nonosteotomy group and 15 patients (75%) in the osteotomy group developed a limp (P < .0001). Three patients (13%) developed femoral nerve palsy in the nonosteotomy group, but they all recovered completely within 6 months after the surgery. Nineteen patients in the nonosteotomy group showed knee valgus deformity immediately after the surgery but only 4 cases in the osteotomy group.
  
  
  
  Compared with THA with femoral shortening osteotomy, THA without the osteotomy was associated with a lower number of patients who developed a limp at the end of follow-up; however, the rehabilitation was slower and more difficult, and a larger number of patients showed reversible nerve palsy and knee valgus deformity.
authors.affiliation: Department of Orthopaedics, Shanghai No. 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
authors.forename: Huiwu
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Shanghai No. 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
authors.forename: Jiawei
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, Shanghai No. 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Qu
authors.affiliation: Department of Orthopaedics, Shanghai No. 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
authors.forename: Yuanqing
authors.initials: Y
authors.lastname: Mao
authors.affiliation: Department of Orthopaedics, Shanghai No. 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
authors.forename: Kerong
authors.initials: K
authors.lastname: Dai
authors.affiliation: Department of Orthopaedics, Shanghai No. 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
authors.forename: Zhenan
authors.initials: Z
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D006617:Hip Dislocation / Q000601:surgery; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006801:Humans; D007719:Knee Joint; D007870:Leg Length Inequality; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D012189:Retrospective Studies
keywords: comparison study; developmental dysplasia of the hip; femoral shortening osteotomy; high hip dislocation; total hip arthroplasty