Open AccessTotal Hip Arthroplasty with Subtrochanteric Femoral Shortening Osteotomy for High Hip Dislocation
Author(s) -
Hua Wenbin,
Yang Shuhua,
Xu Weihua,
Ye Shunan,
Liu Xianzhe,
Wang Jing,
Feng Yong
Publication year - 2015
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12176
Subject(s) - medicine , osteotomy , surgery , greater trochanter , femoral head , lesser trochanter , femur , acetabulum , fixation (population genetics) , radiography , arthroplasty , population , environmental health
Objective To evaluate the outcomes of total hip arthroplasty (THA) with subtrochanteric femoral shortening osteotomy for high hip dislocation. Methods In this retrospective study, the results of 24 primary THAs with acetabular reconstruction and subtrochanteric femoral shortening osteotomy in 21 patients with high hip dislocation were evaluated. The acetabula were reconstructed with cemented or uncemented cups and bone grafting. Transverse subtrochanteric femoral shortening osteotomies were applied and the osteotomy sites treated by bone grafting and cable fixation. Assessment was by H ip H arris scores and radiographic evaluation. Results The mean follow‐up time was 42 months (18–108 months), three cases being lost to follow‐up 18–27 months postoperatively. The HHS improved from 47.5 ± 8.7 to 88.5 ± 3.1. The mean length of femoral segments removed was 2.5 ± 0.8 cm (range, 1.0–4.5 cm) and mean acetabular inclination 43° ± 5° (range, 31°–54°). Caudalization of the femoral head center was 3.2 ± 3.0 mm (range, −3 to 12 mm) and lateralization 4.0 ± 4.0 mm (range, −9 to 11 mm). Mean greater trochanter height relative to theoretical hip center was 5.2 ± 1.0 cm (range, 3.5–7.1 cm) preoperatively and 0.2 ± 0.6 cm (range, −0.9 to 1.2 cm) postoperatively. Intraoperative trochanteric fractures occurred in three cases and sciatic nerve palsy in one. Conclusion THA with subtrochanteric femoral shortening osteotomy is an effective technique for treating high hip dislocation. Its advantages include improvement in limb imbalance and decreased risk of sciatic nerve injury.