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False acetabulum is preoperative guidance for Crowe type IV hips on hip reduction without femoral shortening during total hip arthroplasty
Author(s) -
Sun JingYang,
Zhang BoHan,
Shen JunMin,
Du YinQiao,
Zhou YongGang
Publication year - 2021
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.17119
Subject(s) - medicine , acetabulum , greater trochanter , surgery , lesser trochanter , total hip arthroplasty , radiography , reduction (mathematics) , femur , hip dysplasia , geometry , mathematics
Background We aimed to analyze if the false acetabulum is a good indicator for determining femoral shortening. Methods We retrospectively included 102 patients with unilateral Crowe type IV developmental dysplasia who underwent primary total hip arthroplasty from April 2008 to May 2019. Based on the presence of false acetabulum, the 102 hips were further classified Crowe IVA group and Crowe IVB group. Radiographic measurement included the height of greater trochanter (HGT) preoperatively and postoperatively, which reflected the distalisation of greater trochanter (DGT). Harris hip score (HHS), limb length discrepancy (LLD), and complications were collected as clinical evaluation. Results Sixty hips were classified into Crowe IVA group, and 42 hips were classified into Crowe IVB group. Within Crowe IVA group, the proportion of hips treated with subtrochanteric osteotomy was significantly higher than that in Crowe IVB group (97% vs. 12%) ( P < 0.001). The DGT in Crowe IVA group was also greater (67 vs. 32 mm) ( P < 0.001). At last follow‐up, both two groups obtained excellent clinical scores. There was no significant difference in postoperative LLD between the two groups ( P = 0.001). Six dislocations occurred and three patients developed femoral nerve palsy, while all recovered in a year. Conclusion The false acetabulum is a promising and good indicator for determining femoral shortening.