Total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe IV developmental dysplasia of the hip

Abstract

Objective To evaluate the clinical efficacy of total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe IV developmental dysplasia of the hip. Methods From September 2003 to September 2012, 21 patients （24 hips） underwent total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe IV developmental dysplasia of the hip in our hospital. There were 3 males and 18 females, aged from 28 to 71 years （average, 54±10 years）. The ceramic- polyethylene articulation was used in 17 patients （20 hips）, and metal-polyethylene articulation in 4 patients （4 hips）. The osteoto- my site was treated with autologous bone graft in 18 patients （21 hips） and allogeneic bone graft in 3 patients （3 hips）. The Harris hip score was used to assess the clinical results. Results A total of 18 patients were followed up for 0.5 to 9 years （average, 3.5 years）. The Harris hip score was improved from preoperative 47.9±9.1 to 88.4±3.5 at 6 months postoperatively. For most patients, hip pain relieved significantly; range of motion of the hip was improved, and the gait returned to normal. Sciatic nerve palsy occurred in 1 patient. There was no wound infection. X-rays 6 months after operation showed that the position of prostheses was satisfactory, without loosening of prostheses and bone block resorption. Conclusion Total hip arthroplasty with subtrochanteric femoral shortening osteotomy can achieve good clinical effect in Crowe IV developmental dysplasia of the hip. Moreover, it can improve leg length discrepancy and decrease the risk of sciatic nerve injury. Key words: Hip dislocation, congenital; Acetabulum; Arthroplasty, replacement, hip