title: Total hip arthroplasty with step-cut subtrochanteric femoral shortening osteotomy in high riding hip dislocated patients with previous femoral osteotomy.
abstract: BACKGROUND
  To evaluate the long-term clinical and radiological outcomes of cementless total hip arthroplasty (THA) in high riding hip dislocated patients with previous proximal femoral osteotomy.
  
  
  METHODS
  Twenty-one consecutive patients with a mean age forty-two years were treated with cementless THA Step-cut subtrochanteric femoral osteotomy was performed in all twenty-eight hips. Metal on polyethylene (MoP) and ceramic on ceramic (CoC) bearings were used in two different consecutive time periods. The mean follow-up time was twelve years. Harris hip score, limb length discrepancy, complications, union status of the osteotomy, survivorship of constructs were the criteria for evaluation.
  
  
  RESULTS
  The mean Harris hip score improved from 39.5 to 88.7 points. The mean limb length discrepancy in unilateral cases decreased from 54.5 mm to 12.3 mm. The mean amount of femoral shortening was 37 mm. The mean union time was 3.5 months and there were no delayed union and non-union. There were three cup and two femoral revisions due to osteolysis in patients who had MoP. There was only one femoral revision in patients who had CoC. The Kaplan Meier survivorship with an end point of any revision of the stem and the acetabular component was 94% (95% CI, 75%-98%) and 92% (95% CI, 74%-99%) at ten years respectively.
  
  
  CONCLUSIONS
  Total hip arthroplasty with subtrochanteric step-cut femoral shortening is a successful technique to improve the hip functions and reconstruct limb length discrepancy in young patients with proximal femoral deformities.
authors.affiliation: Acıbadem University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acıbadem Maslak Hospital, Maslak 34457 Istanbul, Turkey. Electronic address: vahitemre@gmail.com.
authors.forename: Vahit Emre
authors.initials: VE
authors.lastname: Ozden
authors.affiliation: Acıbadem University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acıbadem Maslak Hospital, Maslak 34457 Istanbul, Turkey.
authors.forename: Goksel
authors.initials: G
authors.lastname: Dikmen
authors.affiliation: Acıbadem University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acıbadem Maslak Hospital, Maslak 34457 Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Beksac
authors.affiliation: Acıbadem University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acıbadem Maslak Hospital, Maslak 34457 Istanbul, Turkey.
authors.forename: Ismail Remzi
authors.initials: IR
authors.lastname: Tozun
mesh_terms: D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005544:Forecasting; D006617:Hip Dislocation / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult