A study of total hip arthroplasty with subtrochanteric osteotomy in Crowe type <b>Ⅳ</b> developmental dysplasia of hip _Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SUN Jingyang ,  ZHOU Yonggang , GAO Zhisen , MA Haiyang , PIAO Shang , DU Yinqiao , WU Wenming , PENG Yawen

Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China;

Corresponding author：

ZHOU Yonggang, Email: zhouyg@263.net

Keywords：

Total hip arthroplasty; developmental dysplasia of the hip; subtrochanteric osteotomy; Crowe classification

DOI：

10.7507/1002-1892.201708004

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

ObjectiveTo evaluate the effectiveness of total hip arthroplasty (THA) combined with subtrochanteric osteotomy in the treatment of Crowe type Ⅳdevelopmental dysplasia of the hip (DDH).MethodsBetween April 2008 and June 2016, 71 patients with unilateral Crowe type Ⅳ DDH were treated with THA. Of 71 cases, 44 were performed with subtrochanteric osteotomy (osteotomy group) and 27 were performed without subtrochanteric osteotomy (non-osteotomy group). There was no significant difference in gender, age, body mass, height, body mass index, affected side, and preoperative Harris score between 2 groups (P>0.05). The complications were recorded and the effectiveness was assessed by Harris score. Besides, the femoral dislocation height and the settling depth of sleeve were measured in the pelvic anteroposterior X-ray film pre- and post-operatively.ResultsOsteotomy group was followed up 12-90 months (mean. 34.77 months), and non-osteotomy group was followed up 12-79 months (mean, 34.33 months). There was no significant difference in follow-up time between 2 groups (t=–0.088, P=0.930). There was 11 cases of intraoperative or postoperative complications in osteotomy group, and 3 cases of postoperative complications in non-osteotomy group. Among the osteotomy group, 1 case had nonunion due to infection and received revision after 20 months. No loosening or dislocation of the implant occurred in both 2 groups. Significant differences were found in femoral dislocation height and settling depth of sleeve between 2 groups (t=–8.452, P=0.000; t=6.783, P=0.000). Moreover, the osteotomy length was not correlated with the settling depth of sleeve (r=–0.038, P=0.806). At last follow-up, there was no significant difference in Harris score between 2 groups (t=–1.160, P=0.254).ConclusionTHA combined with subtrochanteric osteotomy can provide a favorable outcome for treating Crowe type Ⅳ DDH. Furthermore, patients with higher femoral dislocation and severely narrow femoral proximal canals are prone to be peformed with subtrochanteric osteotomy.

Citation： SUN Jingyang, ZHOU Yonggang, GAO Zhisen, MA Haiyang, PIAO Shang, DU Yinqiao, WU Wenming, PENG Yawen. A study of total hip arthroplasty with subtrochanteric osteotomy in Crowe type Ⅳ developmental dysplasia of hip . Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(2): 152-156. doi: 10.7507/1002-1892.201708004 Copy

1.	Zhou Y, Sun C, Wang Y. New method addressing the problem of using ceramic-on-ceramic bearing in too small acetabulum of high-riding DDH patients with THA. Seminars in Arthroplasty, 2012, 23(4): 226-31.
2.	Liu S, Zuo J, Li Z, et al. Study of three-dimensional morphology of the proximal femur in developmental adult dysplasia of the hip suggests that the on-shelf modular prosthesis may not be an ideal choice for patients with Crowe type Ⅳ hips. Int Orthop, 2017, 41(4): 707-713.
3.	Sonohata M, Kitajima M, Kawano S, et al. Nerve palsy after total hip arthroplasty without subtrochanteric femoral shortening osteotomy for a completely dislocated Hip joint. Open Orthop J, 2016, 10: 785-792.
4.	Kilicarslan K, Yalcin N, Cicek H, et al. What happens at the adjacent knee joint after total hip arthroplasty of Crowe type Ⅲ and Ⅳ dysplastic hips? J Arthroplasty, 2012, 27(2): 266-270.
5.	陈涛, 杨春喜. 人工全髋关节置换术治疗 Crowe Ⅳ型先天性髋关节发育不良截骨术的研究进展. 中国修复重建外科杂志, 2015, 29(4): 444-447.
6.	Yan F, Chen G, Yang L, et al. A reduction technique of arthroplasty without subtrochanteric femoral shortening osteotomy for the treatment of developmental high dislocation of hip: a case series of 28 hips. J Arthroplasty, 2014, 29(12): 2289-2293.
7.	Zhao X, Zhu ZA, Xie YZ, et al. Total hip replacement for high dislocated hips without femoral shortening osteotomy. J Bone Joint Surg (Br), 2011, 93(9): 1189-1193.
8.	周勇刚, 张强, 王岩, 等. 两种不同截骨方法治疗 Crowe Ⅳ型先天性髋脱位的比较研究. 中华外科杂志, 2008, 46(17): 1288-1292.
9.	Krych AJ, Howard JL, Trousdale RT, et al. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-Ⅳ developmental dysplasia. J Bone Joint Surg (Am), 2009, 91(9): 2213-2221.
10.	Ollivier M, Abdel MP, Krych AJ, et al. Long-term results of total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe Ⅳ developmental dysplasia. J Arthroplasty, 2016, 31(8): 1756-1760.
11.	Wang D, Li LL, Wang H Y, et al. Long-term results of cementless total hip arthroplasty with subtrochanteric shortening osteotomy in Crowe type Ⅳ developmental dysplasia. J Arthroplasty, 2017, 32(4): 1211-1219.
12.	汪强, 孙俊英, 金晔, 等. S-ROM 股骨柄假体的设计特征与初次全髋置换. 中国组织工程研究, 2012, 16(17): 3061-3064.
13.	赵唐永, 任原, 王志强. 股骨干骨折内固定术后骨折愈合情况及其影响因素分析. 中国骨与关节损伤杂志, 2015, 30(8): 869-870.
14.	马海洋, 周勇刚, 郑充, 等. Crowe Ⅳ型髋关节发育不良的新分型. 中国骨伤, 2016, 29(2): 119-124.
15.	Wu X, Li SH, Lou LM, et al. The techniques of soft tissue release and true socket reconstruction in total hip arthroplasty for patients with severe developmental dysplasia of the hip. Int Orthop, 2012, 36(9): 1795-1801.
16.	Wu X, Lou LM, Li SH, et al. Soft tissue balancing in total hip arthroplasty for patients with adult dysplasia of the hip. Orthop Surg, 2009, 1(3): 212-215.
17.	Li Y, Zhang X, Wang Q, et al. Equalisation of leg lengths in total hip arthroplasty for patients with Crowe type-Ⅳ developmental dysplasia of the hip: classification and management. Bone Joint J, 2017, 99-B(7): 872-879.
18.	Li YM, Li JH, Li B, et al. The radiological research for pelvis asymmetry of unilateral developmental dysplasia of the hip in adult. Saudi Med J, 2016, 37(12): 1344-1349.

1. Zhou Y, Sun C, Wang Y. New method addressing the problem of using ceramic-on-ceramic bearing in too small acetabulum of high-riding DDH patients with THA. Seminars in Arthroplasty, 2012, 23(4): 226-31.
2. Liu S, Zuo J, Li Z, et al. Study of three-dimensional morphology of the proximal femur in developmental adult dysplasia of the hip suggests that the on-shelf modular prosthesis may not be an ideal choice for patients with Crowe type Ⅳ hips. Int Orthop, 2017, 41(4): 707-713.
3. Sonohata M, Kitajima M, Kawano S, et al. Nerve palsy after total hip arthroplasty without subtrochanteric femoral shortening osteotomy for a completely dislocated Hip joint. Open Orthop J, 2016, 10: 785-792.
4. Kilicarslan K, Yalcin N, Cicek H, et al. What happens at the adjacent knee joint after total hip arthroplasty of Crowe type Ⅲ and Ⅳ dysplastic hips? J Arthroplasty, 2012, 27(2): 266-270.
5. 陈涛, 杨春喜. 人工全髋关节置换术治疗 Crowe Ⅳ型先天性髋关节发育不良截骨术的研究进展. 中国修复重建外科杂志, 2015, 29(4): 444-447.
6. Yan F, Chen G, Yang L, et al. A reduction technique of arthroplasty without subtrochanteric femoral shortening osteotomy for the treatment of developmental high dislocation of hip: a case series of 28 hips. J Arthroplasty, 2014, 29(12): 2289-2293.
7. Zhao X, Zhu ZA, Xie YZ, et al. Total hip replacement for high dislocated hips without femoral shortening osteotomy. J Bone Joint Surg (Br), 2011, 93(9): 1189-1193.
8. 周勇刚, 张强, 王岩, 等. 两种不同截骨方法治疗 Crowe Ⅳ型先天性髋脱位的比较研究. 中华外科杂志, 2008, 46(17): 1288-1292.
9. Krych AJ, Howard JL, Trousdale RT, et al. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-Ⅳ developmental dysplasia. J Bone Joint Surg (Am), 2009, 91(9): 2213-2221.
10. Ollivier M, Abdel MP, Krych AJ, et al. Long-term results of total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe Ⅳ developmental dysplasia. J Arthroplasty, 2016, 31(8): 1756-1760.
11. Wang D, Li LL, Wang H Y, et al. Long-term results of cementless total hip arthroplasty with subtrochanteric shortening osteotomy in Crowe type Ⅳ developmental dysplasia. J Arthroplasty, 2017, 32(4): 1211-1219.
12. 汪强, 孙俊英, 金晔, 等. S-ROM 股骨柄假体的设计特征与初次全髋置换. 中国组织工程研究, 2012, 16(17): 3061-3064.
13. 赵唐永, 任原, 王志强. 股骨干骨折内固定术后骨折愈合情况及其影响因素分析. 中国骨与关节损伤杂志, 2015, 30(8): 869-870.
14. 马海洋, 周勇刚, 郑充, 等. Crowe Ⅳ型髋关节发育不良的新分型. 中国骨伤, 2016, 29(2): 119-124.
15. Wu X, Li SH, Lou LM, et al. The techniques of soft tissue release and true socket reconstruction in total hip arthroplasty for patients with severe developmental dysplasia of the hip. Int Orthop, 2012, 36(9): 1795-1801.
16. Wu X, Lou LM, Li SH, et al. Soft tissue balancing in total hip arthroplasty for patients with adult dysplasia of the hip. Orthop Surg, 2009, 1(3): 212-215.
17. Li Y, Zhang X, Wang Q, et al. Equalisation of leg lengths in total hip arthroplasty for patients with Crowe type-Ⅳ developmental dysplasia of the hip: classification and management. Bone Joint J, 2017, 99-B(7): 872-879.
18. Li YM, Li JH, Li B, et al. The radiological research for pelvis asymmetry of unilateral developmental dysplasia of the hip in adult. Saudi Med J, 2016, 37(12): 1344-1349.

Chinese Journal of Reparative and Reconstructive Surgery

A study of total hip arthroplasty with subtrochanteric osteotomy in Crowe type Ⅳ developmental dysplasia of hip

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content