Objective: To compare the clinical effects of total hip arthroplasty(THA) with non-osteotomy and subtrochanteric osteotomy in the treatment of Crowe type IV hip dysplasia (DDH) in adults.
Methods: Data of 35 Crowe type IV DDH patients who underwent THA were analyzed retrospectively, the patients were divided into two groups:15 cases of non-osteotomy and 20 cases of subtrochanteric osteotomy. There was no significant difference in age, gender, body mass index between two groups (>0.05). The operative time, bleeding volume, hospitalization duration, Harris hip score and the limb length discrepancy (LLD) were evaluated.
Results: All of the patients were followed up for 12 to 48 months, no prosthesis loosening or infection occurred by the end of follow-up. In non-osteotomy group, 1 case had occurred by sciatic nerve injury and 1 case developed cutaneous branch injury of the femoral nerve, both of which were spontaneously recovered completely without treatment after 3 months. One case of dislocation occurred in subtrochanteric osteotomy group, after closed reduction, dislocation did not recur; three cases had proximal femoral crack fractures and received steel plate fixation; no reoperation was needed. There was significant difference in operation duration, bleeding volume, and hospitalization days between two groups(<0.05). The Harris score at last follow-up was significantly increased compared with preoperative score in two groups(<0.05), but there was no significant difference between two groups(>0.05). The postoperative discrepancy of bilateral lower limbs had significant difference(<0.05).
Conclusions: THA with no femoral shortening osteotomy can achieve good clinical results in patients with unilateral Crowe IV developmental dysplasia of hip. Comparing with subtrochanteric osteotomy, the procedure of no femoral shortening osteotomy is easier technically. For unilateral high dislocation DDH patients with limb lengthening <=4 cm and good tissue conditions, THA without femoral osteotomy may be considered.
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Article Synopsis
- - The study evaluated the use of Paavilainen osteotomy in combination with total hip arthroplasty (THA) for treating high developmental hip dislocation, focusing on effectiveness and risk factors for nonunion after the procedure.
- - A total of 44 patients were reviewed over an average follow-up of 4.4 years, showing significant improvement in hip function scores, with a 12% incidence of nonunion, which was linked to the length of contact between the osteotomy block and femoral cortex.
- - The research concluded that this combined surgical approach is effective and less complex than other methods for high-dislocation hip dysplasia, with a critical contact length of 2.15 cm identified as essential for
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