成人脱臼性股関節症に対する転子下短縮骨切りを併用した人工股関節全置換術（ＴＨＡ）の経験

Abstract

Complete congenital dislocation of the hip is one of the most challenging reconstructions in hip arthroplasty. The distorted anatomy in this hip include a high hip center, a small femoral canal, leg length discrepancy, soft tissue contractures, and increased anteversion of the femoral neckshaft angle. Therefore, total hip arthroplasty in CDH has been associated with higher failure and complication rates.We report a case of total hip arthroplasty using subtrochanteric femoral shortening via transverse osteotomy unilateral high-riding congenital dislocation of the hip. This shortening technique was used with non-cemented components, reinforced with bicortical autograft struts and cables. Noncemented acetabular reconstruction was performed at the level of the true acetabulum without bone grafting.The time to union of the osteotomy site was 4 months. JOA scores improved from 52 points preoperatively to 76 points at the latest follow-up at 6 months after surgery.