Total hip arthroplasty without subtrochanteric femoral osteotomy is possible in patients with Crowe III/IV developmental dysplasia: total hip arthroplasty without femoral osteotomy

Arch Orthop Trauma Surg. 2020 Mar;140(3):409-413. doi: 10.1007/s00402-019-03320-6. Epub 2019 Dec 7.

Abstract

Background: We aimed to present our THA technique without femoral shortening osteotomy that we perform for the treatment of coxarthrosis on Crowe type III/IV developmental dysplasia of the hip and to present the early clinical outcomes of our patients.

Methods: 77 patients with Crowe type III/IV developmental dysplasia of the hip, who had admitted to our clinic between 2013 and 2017, and had undergone cementless THA without femoral shortening by a single surgeon, were retrospectively evaluated. Patients were called for a final evaluation and assessed by Harris Hip Score. Trendelenburg sign was observed. For radiological evaluation, routine anteroposterior and lateral hip radiography and orthoroentgenogram was used.

Results: Mean duration of follow-up was 38.2 (22-52) months. Pre-operative mean Harris Hip Score was 53.9 (49-62) and post-operative mean value was 82.7 (76-95). Mean duration of operation was 44.9 (39-57) min. In post-operative final evaluation only three patients (3.8%) had positive Trendelenburg sign. 3 patients (3.8%) had early dislocation. No sciatic palsy was observed in any of the patients. Revision with acetabular cage was performed for one (1.2%) patient due to protrusion development in the acetabular cup. The mean prosthesis survival rate was 98.8%.

Conclusions: Total hip arthroplasty without femoral osteotomy can be considered as a successful method in selected patients with Crowe III/IV coxarthrosis. It provides good clinical outcomes in the early period, reduces surgery duration, has acceptable complication rates, has high prosthesis survival rates.

Keywords: Arthroplasty; Femoral shortening; Hip; Osteotomy.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Hip* / methods
  • Arthroplasty, Replacement, Hip* / statistics & numerical data
  • Femur / surgery*
  • Hip Dislocation, Congenital / surgery*
  • Humans
  • Postoperative Complications
  • Prosthesis Failure
  • Retrospective Studies