Total hip arthroplasty in patients with coxarthrosis due to developmental dysplasia of the hip: Is fixation of the subtrochanteric osteotomy necessary?
Hakan Atalar1
, Alim Can Baymurat1, İbrahim Kaya2, Mehmet Ali Tokgöz1, Tolga Tolunay1, Şefik Murat Arikan1
1Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Türkiye
2Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye
Keywords: Developmental dysplasia of the hip, rectangular femoral component, total hip arthroplasty, transverse subtrochanteric shortening osteotomy
Abstract
Objectives: This study aims to analyze the clinical, functional, and radiographic results of patients with Crowe type IV developmental dysplasia of the hip (DDH) sequelae undergoing cementless total hip arthroplasty (THA) with transverse subtrochanteric shortening osteotomy without fixation at the osteotomy site.
Patients and methods: Between March 2013 and February 2020, a total of 42 hips of 34 patients (8 males, 26 females; mean age: 50.7±11.7 years; range, 27 to 76 years) with Crowe type IV DDH treated with subtrochanteric shortening osteotomy combined with primary cementless THA were retrospectively analyzed. Each case was evaluated to the Harris Hip Score (HHS). Crowe classification, location of the rotation center of hip, loosening of the implants, and union at the osteotomy line were evaluated radiologically.
Results: The mean follow-up was 57.9±31.5 (range, 24 to 192) months. The mean interval to complete bone union in 40 hips (95%) after surgery was 3.5±0.9 (range, 2 to 6) months. The mean preoperative HHS scores of the patients was 35.6±6.86, while the scores increased to 91.53±5.41 at the final follow-up (p<0.001).
Conclusion: Our study results suggest that excellent clinical and radiological results can be obtained in Crowe type IV dysplastic hips in patients undergoing THA with the rectangular femoral component and transverse shortening osteotomy technique, without fixation at the osteotomy site.
Citation: Atalar H, Baymurat AC, Kaya İ, Tokgöz MA, Tolunay T, Arikan ŞM. Total hip arthroplasty in patients with coxarthrosis due to developmental dysplasia of the hip: Is fixation of the subtrochanteric osteotomy necessary?. Jt Dis Relat Surg 2023;34(3):605-612. doi: 10.52312/jdrs.2023.1091.
The study protocol was approved by the Medicine Faculty of Gazi University Ethics Committee (date: 22.02.2022 no: 04). The study was conducted in accordance with the principles of the Declaration of Helsinki.
Idea/concept and design: H.A., Ş.M.A.; Data collection and/or processing: İ.K., M.A.T.; Analysis and/or interpretation and control/supervision: H.A., A.C.B.; Literature review: H.A., A.C.B., İ.K.; Writing the article: H.A., İ.K., M.A.T.; Critical review: T.T., Ş.M.A.; References and fundings: H.A., Ş.M.A.; Materials: M.A.T.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
A written informed consent was obtained from each patient.
The data that support the findings of this study are available from the corresponding author upon reasonable request.