Journal List > Hip Pelvis > v.26(1) > 1082035

Kim, Lee, Min, Bae, and Jang: Cementless Total Hip Arthroplasty with Subtrochanteric Transverse Shortening Osteotomy in Patients with High Hip Dislocation

Abstract

Purpose

The purpose of this study was to evaluate the clinical and radiographic results of cementless total hip arthroplasty (THA) with subtrochanteric transverse shortening osteotomy in patients with high hip dislocation.

Materials and Methods

Eighteen patients with high hip dislocation who underwent cementless THA combined with a subtrochanteric transverse shortening osteotomy, plate or cable fixation and bone graft on the osteotomy site between 2001 and 2012 were evaluated in this study. The mean duration of follow-up was 5.2 (2-8.3) years. We evaluated Harris hip score, limping, limb length discrepancy as a clinical parameter and osteolysis, loosening and union of the osteotomy site as a radiographic parameter.

Results

Harris hip scores at the final follow-up showed improvement of limping and limb length discrepancy in all cases. And, with the exception of two cases of infection, there were no loosening and osteolysis. All cases showed union of the osteotomy site. There were two cases of infection and one case of dislocation as a complication. Infection occurred in two patients who underwent reoperation and one patient developed sciatic nerve palsy.

Conclusion

Cementless THA with subtrochanteric transverse shortening osteotomy showed relatively satisfactory clinical and radiologic results. However, the incidence of complications, such as infection, is relatively high, therefore, careful attention is needed.

Figures and Tables

Fig. 1
(A) A preoperative radiograph shows Crowe classification 4 high dislocation of the right hip with about 6 cm limb-length discrepancy. (B) A postoperative radiograph shows the hip after femoral shortening and total hip replacement on the right side. (C) A postoperative radiograph after 4.5 years shows healing of the osteotomy site and incorporation of the prosthesis.
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Fig. 2
(A) A preoperative radiograph shows Crowe classification 4 high dislocation of the left hip. (B) A postoperative radiograph shows the hip after femoral shortening and total hip replacement on the left side. (C) A postoperative radiographs show after 6 months acetabular cup loosening caused by infection and after management of infected total hip replacement with PROSTALAC®. But, well-fixed femoral stem was retained. (D) A postoperative radiograph after the second stage revision shows no evidence of periprosthetic osteolysis and implant loosening.
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Table 1
Clinical Results
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Values are presented as data (range) or data only.

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