Abstract
BackgroundIn developing countries hip osteoarthritis constitutes a major public health issue as it is highly prevalent in all age ranges of population, including the young. It often remains untreated because of the low accessibility of total hip prostheses. Hip arthrodesis still represents a major treatment option, but, for several reasons which are discussed in this paper, is nowadays infrequently performed. By means of reporting the results of a new simple technique, using a self-devised plate, the relevancy of hip arthrodesis in this particular environment is emphasized.Methods and FindingsOur series included 35 patients with painful hip osteoarthritis who underwent a hip fusion with the anterolateral arthrodesis plate. Two of them had a concurrent femoral osteotomy for correction of a vicious position of the limb and another patient had a femoral diaphysis osteotomy and placement of a Wagner elongating device in order to proceed with a limb lengthening by callotasis. The follow-up period averaged 16,9 months (9 to 34). All hips, except two, achieved solid fusion between 6 and 15 months after surgery. One failure of fusion was in the oldest patient, who presented a loosening of plate and screws due to an advanced degree of osteoporosis; the other was in a young patient who admitted having walked on his leg too soon. Patient satisfaction was high. We concluded that this technique is reliable and effective.ConclusionsThe results of this study should convince the hesitant surgeon and patient to consider hip arthrodesis an acceptable treatment option for disabling hip arthritis, compared to no treatment at all.
Highlights
Total hip prostheses are often too expensive and their availability too limited to cover the needs of patients with a painful osteoarthritic hip in developing countries
To improve the image of hip arthrodesis (HA) and to offer the opportunity to help patients who otherwise would remain untreated, the senior author (PH) has devised a new simple technique for HA based on a self-designed plate, the ‘‘anterolateral arthrodesis plate’’
In all patients the hip flexion could be corrected per-operatively to standards for hip arthrodesis position, except in two who required a concurrent femoral subtrochanteric osteotomy in order to correct the vicious position of the limb
Summary
Total hip prostheses are often too expensive and their availability too limited to cover the needs of patients with a painful osteoarthritic hip in developing countries. This is why in those regions of the world, hip arthrodesis remains a major treatment option. In developing countries hip osteoarthritis constitutes a major public health issue as it is highly prevalent in all age ranges of population, including the young. It often remains untreated because of the low accessibility of total hip prostheses. By means of reporting the results of a new simple technique, using a selfdevised plate, the relevancy of hip arthrodesis in this particular environment is emphasized
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