Crowe IV developmental dysplasia treated by total hip arthroplasty with subtrochanteric osteotomy / 中国组织工程研究

ABSTRACT

BACKGROUND:Crowe IV developmental dysplasia of the hip is rarely seen clinical y. However, when treated with routine total hip arthroplasty, severe deformities in the bone and soft tissue can lead to high rate of operation failure and increased occurrence of complications. Total hip arthroplasty in combination with subtrochanteric osteotomy may be an option to resolve this problem. OBJECTIVE:To retrospectively analyze the clinical outcome and safety of Crowe IV developmental dysplasia of the hip treated by the combination of total hip arthroplasty and subtrochanteric osteotomy in 17 cases. METHODS:Twenty-one hips (17 cases) of Crowe IV developmental dysplasia of the hip treated by the combination of total hip arthroplasty and subtrochanteric osteotomy were retrospectively analyzed and fol owed for at least 2 years from January 2006 to June 2011. Complications, hip function, and radiological changes were evaluated. RESULTS AND CONCLUSION:The mean fol ow-up period was (48.0±20.5) months. Harris’s score was increased postoperatively (P<0.05). The main complains were lower limb length discrepancy, difficulty in standing up from squatting, muscle weakness, and soft tissue tightness. One greater trochanter fracture occurred and was fixed by hook plate fixation. There were four femoral shaft splits treated by cerclage. One patient represented with femoral nerve palsy and got partial recovery until the latest fol ow-up. There was no deep infection, dislocation or prosthesis loosening. Crowe IV developmental dysplasia of the hip could be effectively treated by total hip arthroplasty in combination with subtrochanteric osteotomy, which requires high surgical techniques to control the complications. Further fol ow-up is required for long-term results.