Mid-term effectiveness of total hip arthroplasty with subtrochanteric shortening osteotomy in treatment of Crowe type <b>Ⅳ</b> developmental dysplasia of hip _Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YIN Shijiu , LI Ruibo , MOU Ping , ZHONG Hang ,  YANG Jing

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

YANG Jing, Email: cd-yangjing@163.com

Keywords：

Developmental dysplasia of the hip; total hip arthroplasty; subtrochanteric osteotomy; mid-term effectiveness

DOI：

10.7507/1002-1892.201711053

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ObjectiveTo explore the mid-term effectiveness of total hip arthroplasty (THA) with subtrochanteric shortening osteotomy in treatment of Crowe type Ⅳ developmental dysplasia of the hip (DDH).MethodsBetween September 2009 and March 2014, a total of 49 patients (57 hips) who were diagnosed with Crowe type Ⅳ DDH were treated with THA and subtrochanteric shortening osteotomy. Of the 49 patients, 7 were male and 42 were female with an average age of 44.6 years (range, 20-73 years). The preoperative Harris score was 44.68±3.39 and the preoperative leg length discrepancy was (5.27±0.55) cm.ResultsAll incisions healed primarily. All patients were followed up 32-87 months (mean, 52.1 months). At last follow-up, the Harris score was 85.67±2.89 and the leg length discrepancy was (1.12±0.48) cm, showing significant differences when compared with the preoperative values (t=–69.53, P=0.00; t=42.94, P=0.00). X-ray films showed that bone union of the femoral osteotomy end at 6 months after operation. There was no loosening and subsidence of prosthesis at last follow-up.ConclusionThe subtrochanteric shortening osteotomy with THA in treatment of Crowe type Ⅳ DDH can obtain satisfactory mid-term effectiveness with low risk of peripheral vascular and nerve traction injuries.

Citation： YIN Shijiu, LI Ruibo, MOU Ping, ZHONG Hang, YANG Jing. Mid-term effectiveness of total hip arthroplasty with subtrochanteric shortening osteotomy in treatment of Crowe type Ⅳ developmental dysplasia of hip . Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(4): 385-388. doi: 10.7507/1002-1892.201711053 Copy

1.	Hasegwawa Y, Iwata H. Natural history of unreduced congenital dislocation of the hip in adults. Arch Orthop Trauma Surg, 2000, 120(1-2): 17-22.
2.	Li H, Xu J, Qu X, et al. Comparison of total hip arthroplasty with and without femoral shortening osteotomy for unilateral mild to moderate high hip dislocation. J Arthroplasty, 2017, 32(3): 849-856.
3.	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.
4.	Ozden VE, Dikmen G, Beksac B, et al. Total hip arthroplasty with step-cut subtrochanteric femoral shortening osteotomy in high riding hip dislocated patients with previous femoral osteotomy. J Orthop Sci, 2017, 22(3): 517-523.
5.	Reikeraas O, Lereim P, Gabor I, et al. Femoral shortening in total arthroplasty for completely dislocated hips: 3-7 year results in 25 cases. Acta Orthop Scand, 1996, 67(1): 33-36.
6.	Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type Ⅳdevelopmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
7.	Bernasek TL, Haidukewych GJ, Gustke KA, et al. Total hip arthroplasty requiring subtrochanteric osteotomy for developmental hip dysplasia: 5- to 14-year results. J Arthroplasty, 2007, 22(6 Suppl 2): 145-150.
8.	Sanchez-Sotelo J, Berry DJ, Trousdale RT, et al. Surgical treatment of developmental dysplasia of the hip in adults: Ⅱ. Arthroplasty options. J Am Acad Orthop Surg, 2002, 10(5): 334-344.
9.	Masonis JL, Patel JV, Miu A, et al. Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. J Arthroplasty, 2003, 18(3 Suppl 1): 68-73.
10.	Sener N, Tözűn IR, Aşik M. Femoral shortening and cementless arthroplasty in high congenital dislocation of the hip. J Arthroplasty, 2002, 17(1): 41-48.
11.	Becker DA, Gustilo RB. Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplasty, 1995, 10(3): 313-318.
12.	Zhao ZS, Sun JY. Total hip arthroplasty using S-ROM prosthesis in elder patients with type C and B bone. J Orthop, 2013, 10(2): 65-69.
13.	Zhong C, Cai XZ, Yan SG, et al. S-ROM modular arthroplasty combined with transverse subtrochanteric shortening for Crowe type Ⅳ congenital dislocation of hip. Chin Med J (Engl), 2011, 124(23): 3891-3895.
14.	Lim SJ, Moon YW, Eun SS, et al. Total hip arthroplasty using the S-ROM modular stem after joint-preserving procedures for osteonecrosis of the femoral head. J Arthroplasty, 2008, 23(4): 495-501.
15.	Erdemli B, Yilmaz C, Atalar H, et al. Total hip arthroplasty in developmental high dislocation of the hip. J Arthroplasty, 2005, 20(8): 1021-1028.
16.	Eskelinen A, Helenius I, Remes V, et al. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone and Joint Surg (Am), 2006, 88(1): 80-91.
17.	Chareancholvanich K, Becker DA, Gustilo RB. Treatment of congenital dislocated hip by arthroplasty with femoral shortening. Clin Orthop Relat Res, 1999, (360): 127-135.
18.	Huo MH, Zatorski LE, Keggi KJ. Oblique femoral osteotomy in cementless total hip arthroplasty. Prospective consecutive series with a 3-year minimum follow-up period. J Arthroplasty, 1995, 10(3): 319-327.
19.	Li X, Lu Y, Sun J, et al. Treatment of Crowe type-Ⅳ hip dysplasia using cementless total hip arthroplasty and double chevron subtrochanteric shortening osteotomy: A 5- to 10-year follow-up study. J Arthroplasty, 2017, 32(2): 475-479.
20.	Çatma MF, Ünlü S, Öztürk A, et al. Femoral shortening osteotomy in total hip arthroplasty for severe dysplasia: a comparison of two fixation techniques. Int Orthop, 2016, 40(11): 2271-2276.

1. Hasegwawa Y, Iwata H. Natural history of unreduced congenital dislocation of the hip in adults. Arch Orthop Trauma Surg, 2000, 120(1-2): 17-22.
2. Li H, Xu J, Qu X, et al. Comparison of total hip arthroplasty with and without femoral shortening osteotomy for unilateral mild to moderate high hip dislocation. J Arthroplasty, 2017, 32(3): 849-856.
3. 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.
4. Ozden VE, Dikmen G, Beksac B, et al. Total hip arthroplasty with step-cut subtrochanteric femoral shortening osteotomy in high riding hip dislocated patients with previous femoral osteotomy. J Orthop Sci, 2017, 22(3): 517-523.
5. Reikeraas O, Lereim P, Gabor I, et al. Femoral shortening in total arthroplasty for completely dislocated hips: 3-7 year results in 25 cases. Acta Orthop Scand, 1996, 67(1): 33-36.
6. Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type Ⅳdevelopmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
7. Bernasek TL, Haidukewych GJ, Gustke KA, et al. Total hip arthroplasty requiring subtrochanteric osteotomy for developmental hip dysplasia: 5- to 14-year results. J Arthroplasty, 2007, 22(6 Suppl 2): 145-150.
8. Sanchez-Sotelo J, Berry DJ, Trousdale RT, et al. Surgical treatment of developmental dysplasia of the hip in adults: Ⅱ. Arthroplasty options. J Am Acad Orthop Surg, 2002, 10(5): 334-344.
9. Masonis JL, Patel JV, Miu A, et al. Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. J Arthroplasty, 2003, 18(3 Suppl 1): 68-73.
10. Sener N, Tözűn IR, Aşik M. Femoral shortening and cementless arthroplasty in high congenital dislocation of the hip. J Arthroplasty, 2002, 17(1): 41-48.
11. Becker DA, Gustilo RB. Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplasty, 1995, 10(3): 313-318.
12. Zhao ZS, Sun JY. Total hip arthroplasty using S-ROM prosthesis in elder patients with type C and B bone. J Orthop, 2013, 10(2): 65-69.
13. Zhong C, Cai XZ, Yan SG, et al. S-ROM modular arthroplasty combined with transverse subtrochanteric shortening for Crowe type Ⅳ congenital dislocation of hip. Chin Med J (Engl), 2011, 124(23): 3891-3895.
14. Lim SJ, Moon YW, Eun SS, et al. Total hip arthroplasty using the S-ROM modular stem after joint-preserving procedures for osteonecrosis of the femoral head. J Arthroplasty, 2008, 23(4): 495-501.
15. Erdemli B, Yilmaz C, Atalar H, et al. Total hip arthroplasty in developmental high dislocation of the hip. J Arthroplasty, 2005, 20(8): 1021-1028.
16. Eskelinen A, Helenius I, Remes V, et al. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone and Joint Surg (Am), 2006, 88(1): 80-91.
17. Chareancholvanich K, Becker DA, Gustilo RB. Treatment of congenital dislocated hip by arthroplasty with femoral shortening. Clin Orthop Relat Res, 1999, (360): 127-135.
18. Huo MH, Zatorski LE, Keggi KJ. Oblique femoral osteotomy in cementless total hip arthroplasty. Prospective consecutive series with a 3-year minimum follow-up period. J Arthroplasty, 1995, 10(3): 319-327.
19. Li X, Lu Y, Sun J, et al. Treatment of Crowe type-Ⅳ hip dysplasia using cementless total hip arthroplasty and double chevron subtrochanteric shortening osteotomy: A 5- to 10-year follow-up study. J Arthroplasty, 2017, 32(2): 475-479.
20. Çatma MF, Ünlü S, Öztürk A, et al. Femoral shortening osteotomy in total hip arthroplasty for severe dysplasia: a comparison of two fixation techniques. Int Orthop, 2016, 40(11): 2271-2276.

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Mid-term effectiveness of total hip arthroplasty with subtrochanteric shortening osteotomy in treatment of Crowe type Ⅳ developmental dysplasia of hip

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