Total hip arthroplasty (S-ROM stem) and subtrochanteric osteotomy for Crowe type IV developmental dysplasia of the hip

Background Developmental dysplasia of the hip (DDH) in adults with severe pain and disability is best treated by total hip arthroplasty (THA). The purpose of this study was to retrospectively evaluate the outcomes of subtrochanteric shortening osteotomy combined with THA using S-ROM stem for those severe patients with a special focus on the effect of two shapes in the subtrochanteric osteotomy ends: Oblique and transverse. Materials and Methods Twenty one cases with mean age of 43.6 years who met inclusion criteria and were operated between February 2007 and February 2012 were included in the study. Those cases had been divided into two groups (oblique vs. transverse) and all records between the two groups were analyzed. Results The Harris hip score significantly improved from 30.6 (range 18–59) preoperatively to 91.2 (range 87–98) postoperatively by the latest followup. Complications including one deep venous thrombosis, one intraoperative fracture of femur and two dislocations occurred while they were addressed properly afterward. The oblique group showed significant advantages in operative time, union time and additional fixation in comparison with the transverse group. Conclusions In the primary THA for the treatment of irreducible DDH, subtrochanteric oblique osteotomy combined with the freely-rotatable S-ROM stem provided favorable short term outcomes by affording both morphological and functional advantages.

[1]  Liao Wang,et al.  The use of combined anteversion in total hip arthroplasty for patients with developmental dysplasia of the hip. , 2014, The Journal of arthroplasty.

[2]  K. Marumo,et al.  A modified S-ROM stem in primary total hip arthroplasty for developmental dysplasia of the hip. , 2013, The Journal of arthroplasty.

[3]  K. Yoon,et al.  Cementless Total Hip Arthroplasty for Patients with Crowe Type III or IV Developmental Dysplasia of the Hip: Two-Stage Total Hip Arthroplasty Following Skeletal Traction after Soft Tissue Release for Irreducible Hips , 2013, Clinics in orthopedic surgery.

[4]  O. Kilicoglu,et al.  Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation. , 2013, The Journal of arthroplasty.

[5]  D. Berry,et al.  Femoral considerations for total hip replacement in hip dysplasia. , 2012, The Orthopedic clinics of North America.

[6]  H. Crawford,et al.  Early results of total hip arthroplasty in patients with developmental dysplasia of the hip compared with patients with osteoarthritis. , 2012, The Journal of arthroplasty.

[7]  N. Rani,et al.  Total hip arthroplasty with shortening osteotomy in congenital major hip dislocation sequelae. , 2011, Orthopedics.

[8]  M. O. Durakbaşa,et al.  Intermediate-term results after uncemented total hip arthroplasty for the treatment of developmental dysplasia of the hip. , 2010, Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery.

[9]  O. Reikerås,et al.  Femoral Shortening in Total Hip Arthroplasty for High Developmental Dysplasia of the Hip , 2010, Clinical orthopaedics and related research.

[10]  D. Berry,et al.  Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia. , 2009, The Journal of bone and joint surgery. American volume.

[11]  G. Haidukewych,et al.  Total hip arthroplasty requiring subtrochanteric osteotomy for developmental hip dysplasia: 5- to 14-year results. , 2007, The Journal of arthroplasty.

[12]  K. Tallroth,et al.  Cementless total hip arthroplasty in patients with high congenital hip dislocation. , 2006, The Journal of bone and joint surgery. American volume.

[13]  M. Mawatari,et al.  A new device for a V-shaped subtrochanteric osteotomy combined with total hip arthroplasty. , 2006, The Journal of arthroplasty.

[14]  D. Mattingly.  The S-rOM modular femoral stem in dysplasia of the hip. , 2005, Orthopedics.

[15]  A. Spitzer.  The S-ROM cementless femoral stem: history and literature review. , 2005, Orthopedics.

[16]  R. Bourne,et al.  Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. , 2003, The Journal of arthroplasty.

[17]  N. Şener,et al.  Femoral shortening and cementless arthroplasty in high congenital dislocation of the hip. , 2002, The Journal of arthroplasty.

[18]  W. Walsh,et al.  A new technique of subtrochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. , 2000, The Journal of arthroplasty.

[19]  J. Hua,et al.  Uncemented total hip arthroplasty with subtrochanteric derotational osteotomy for severe femoral anteversion. , 1999, The Journal of arthroplasty.

[20]  R. Gustilo,et al.  Treatment of congenital dislocated hip by arthroplasty with femoral shortening. , 1999, Clinical orthopaedics and related research.

[21]  K. Lai,et al.  Use of iliofemoral distraction in reducing high congenital dislocation of the hip before total hip arthroplasty. , 1996, The Journal of arthroplasty.

[22]  M. Huo,et al.  Oblique femoral osteotomy in cementless total hip arthroplasty. Prospective consecutive series with a 3-year minimum follow-up period. , 1995, The Journal of arthroplasty.

[23]  T. Paavilainen,et al.  Cementless total replacement for severely dysplastic or dislocated hips. , 1990, The Journal of bone and joint surgery. British volume.

[24]  P. Sponseller,et al.  Subtrochanteric osteotomy with intramedullary fixation for arthroplasty of the dysplastic hip. A case report. , 1988, The Journal of arthroplasty.

[25]  C. Engh,et al.  Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. , 1987, The Journal of bone and joint surgery. British volume.

[26]  C. Ranawat,et al.  Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. , 1980, The Journal of bone and joint surgery. American volume.

[27]  H. Amstutz,et al.  "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. , 1979, Clinical orthopaedics and related research.

[28]  C. Ranawat,et al.  Total hip replacement in congenital dislocation and dysplasia of the hip. , 1979, The Journal of bone and joint surgery. American volume.

[29]  J. Charnley,et al.  Radiological demarcation of cemented sockets in total hip replacement. , 1976, Clinical orthopaedics and related research.

[30]  L. Riley,et al.  Ectopic ossification following total hip replacement. Incidence and a method of classification. , 1973, The Journal of bone and joint surgery. American volume.