Cementless Total Hip Arthroplasty with Extended Sliding Trochanteric Osteotomy for High Congenital Hip Dislocation: A Retrospective Study

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2017 Apr 7

PMID 28383440

Citations 3

Authors

Zhengliang Luo

Min Chen

Fei Hu

Zhe Ni

Xiaofeng Ji

Xiaoqi Zhang

Peng Cheng

Xifu Shang

Affiliations

Soon will be listed here.

Abstract

Total hip arthroplasty (THA) for high congenital hip dislocation (CHD) is technically demanding. The purpose of this retrospective study was to evaluate the results of cementless THA combined with extended sliding trochanteric osteotomy. We also assessed whether chronic low back pain was relieved after surgery.The study included 19 patients (23 hips) with high CHD treated with cementless THA using extended sliding trochanteric osteotomy technique. Clinical and radiographic outcomes were evaluated.Harris Hip Score, WOMAC score, visual analog scale for low back pain and Trendelenburg sign were significantly improved (P < 0.01) compared with the preoperative. Average limb-length discrepancy in the 15 unilateral hips was reduced from 38.2 ± 7.9 mm to 6.7 ± 4.1 mm (P < 0.01). No dislocation, deep vein thrombosis, or infection occurred. Two patients (8.7%) developed sciatic nerve palsy. One (4.3%) developed symptomatic greater trochanteric bursitis. Two (8.7%) sustained proximal femur shaft fracture during implantation of the femoral component. All femoral components showed successful bony ingrowth at the final follow-up. No stem subsidence was detected. There was no acetabular loosening. Bony union of the reattached greater trochanter was obtained in all hips. Wire breakage occurred in 3 hips (13%).Cementless THA with extended sliding trochanteric osteotomy may be appropriate options for patients with high CHD.

Citing Articles

Greater trochanteric osteotomy and subtrochanteric osteotomy in primary/revision total hip arthroplasty.

Pan Y, Chen Y Front Surg. 2023; 10:1103689.

PMID: 36843986 PMC: 9947351. DOI: 10.3389/fsurg.2023.1103689.

[Effectiveness of proximal femur reconstruction combined with total hip arthroplasty for Crowe type Ⅳ developmental dysplasia of hip].

Tang L, Chen M, Li G, Luo Z, Ji X, Zhang X Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020; 34(6):683-688.

PMID: 32538556 PMC: 8171527. DOI: 10.7507/1002-1892.201911073.

Extended trochanteric osteotomy: improving the access and reducing the risk in revision THA.

Wronka K, Gerard-Wilson M, Peel E, Rolfson O, Cnudde P EFORT Open Rev. 2020; 5(2):104-112.

PMID: 32175097 PMC: 7047899. DOI: 10.1302/2058-5241.5.190005.

References

Engh C, Bobyn J, Glassman A . Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987; 69(1):45-55. DOI: 10.1302/0301-620X.69B1.3818732. View

Offierski C, Macnab I . Hip-spine syndrome. Spine (Phila Pa 1976). 1983; 8(3):316-21. DOI: 10.1097/00007632-198304000-00014. View

Imarisio D, Trecci A, Sabatini L, Uslenghi M, Leone C, Scagnelli R . Cementless total hip replacement for severe developmental dysplasia of the hip: our experience in Crowe's group IV. Musculoskelet Surg. 2012; 97(1):25-30. DOI: 10.1007/s12306-012-0227-y. View

Sugano N, Takao M, Sakai T, Nishii T, Miki H, Ohzono K . Eleven- to 14-year follow-up results of cementless total hip arthroplasty using a third-generation alumina ceramic-on-ceramic bearing. J Arthroplasty. 2011; 27(5):736-41. DOI: 10.1016/j.arth.2011.08.017. View

Baz A, Senol V, Akalin S, Kose O, Guler F, Turan A . Treatment of high hip dislocation with a cementless stem combined with a shortening osteotomy. Arch Orthop Trauma Surg. 2012; 132(10):1481-6. DOI: 10.1007/s00402-012-1560-1. View

Hartofilakidis G, Babis G, Georgiades G, Kourlaba G . Trochanteric osteotomy in total hip replacement for congenital hip disease. J Bone Joint Surg Br. 2011; 93(5):601-7. DOI: 10.1302/0301-620X.93B5.24780. View

Hartofilakidis G, Stamos K, Karachalios T . Treatment of high dislocation of the hip in adults with total hip arthroplasty. Operative technique and long-term clinical results. J Bone Joint Surg Am. 1998; 80(4):510-7. DOI: 10.2106/00004623-199804000-00007. View

Krych A, Howard J, Trousdale R, Cabanela M, Berry D . Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia. J Bone Joint Surg Am. 2009; 91(9):2213-21. DOI: 10.2106/JBJS.H.01024. View

Crowe J, Mani V, Ranawat C . Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979; 61(1):15-23. View

10.

Romero A, Imrie S, Goodman S . Sliding trochanteric osteotomy preserves favorable abductor biomechanics in revision total hip arthroplasty. J Arthroplasty. 2001; 16(1):55-64. DOI: 10.1054/arth.2001.19154. View

11.

Linde F, Jensen J, Pilgaard S . Charnley arthroplasty in osteoarthritis secondary to congenital dislocation or subluxation of the hip. Clin Orthop Relat Res. 1988; 227:164-71. View

12.

Haddad F, Masri B, Garbuz D, Duncan C . Primary total replacement of the dysplastic hip. Instr Course Lect. 2000; 49:23-39. View

13.

Karachalios T, Roidis N, Lampropoulou-Adamidou K, Hartofilakidis G . Acetabular reconstruction in patients with low and high dislocation: 20- to 32-year survival of an impaction grafting technique (named cotyloplasty). Bone Joint J. 2013; 95-B(7):887-92. DOI: 10.1302/0301-620X.95B7.31216. View

14.

Harris W . Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 51(4):737-55. View

15.

Archibeck M, Rosenberg A, Berger R, Silverton C . Trochanteric osteotomy and fixation during total hip arthroplasty. J Am Acad Orthop Surg. 2003; 11(3):163-73. DOI: 10.5435/00124635-200305000-00003. View

16.

Edwards B, Tullos H, Noble P . Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res. 1987; (218):136-41. View

17.

Bal B, Kazmier P, Burd T, Aleto T . Anterior trochanteric slide osteotomy for primary total hip arthroplasty. Review of nonunion and complications. J Arthroplasty. 2006; 21(1):59-63. DOI: 10.1016/j.arth.2005.04.020. View

18.

Perka C, Fischer U, Taylor W, Matziolis G . Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup. J Bone Joint Surg Am. 2004; 86(2):312-9. DOI: 10.2106/00004623-200402000-00014. View

19.

Akiyama H, Kawanabe K, Yamamoto K, Kuroda Y, So K, Goto K . Cemented total hip arthroplasty with subtrochanteric femoral shortening transverse osteotomy for severely dislocated hips: outcome with a 3- to 10-year follow-up period. J Orthop Sci. 2011; 16(3):270-7. DOI: 10.1007/s00776-011-0049-z. View

20.

Rogers B, Garbedian S, Kuchinad R, Backstein D, Safir O, Gross A . Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg Am. 2012; 94(19):1809-21. DOI: 10.2106/JBJS.K.00779. View