Clinical and Radiological Results of Crowe Type 3 or 4 Dysplasia Patients Operated on With Total Hip Arthroplasty Using a Cementless Rectangular Femoral Component Without Fixating or Grafting the Transverse Osteotomy Site |
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| Affiliation: | 1. Department of Orthopedics and Traumatology, Istanbul Taksim Training and Research Hospital, Istanbul, Turkey;2. Nisantasi Orthopaedics Center, Istanbul, Turkey;3. Department of Orthopaedics and Traumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey;1. Department of Orthopaedics and Traumatology, Cerrahpasa Medical School, Istanbul University, Fatih, Istanbul 34098, Turkey;2. Department of Orthopaedics and Traumatology, Istanbul Cerrahi Hospital, Hakkı Yeten Cad., Ferah Sok. No: 22, Fulya, Istanbul 34365, Turkey;1. Takai Hospital, Orthopedic Department, Hirakata, Japan;2. Funabashi Orthopedic Hospital, Joint Reconstruction Center, Funabashi, Japan;1. Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea;2. Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY;3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea;4. Department of Orthopaedic Surgery, Kaoshiung Medical University Hospital, Kaohsiung, Taiwan;5. Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, MN;6. Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA;7. Department of Orthopedic and Trauma Surgery, RWTH Aachen University, Aachen, Germany;8. Department of Rheumatology and Physical Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium;9. Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA;10. Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea;11. Hôpital Henri Mondor, Creteil, France;12. Department of Orthopedic Surgery, Mercy Medical Center, Baltimore, MD;13. Department of Orthopaedic Surgery, Brigham and Women''s Hospital, Boston, MA;14. Department of Orthopaedic Surgery, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;15. Department of Orthopaedic Surgery, Center for Metabolism and Obesity Research, Johns Hopkins, University School of Medicine, Baltimore, MD;p. Department of Trauma & Orthopaedics, Addenbrooke''s, Cambridge University Hospitals, Cambridge, UK;q. Center for Excellence in Hip Disorders, Scottish Rite Hospital for Children, UT Southwestern Medical Center, Dallas, TX;r. Department of Orthopedic Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea;s. Department of Orthopedic Surgery, KonKuk University Medical Center, Seoul, South Korea;t. Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, South Korea;u. Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;v. Department of Internal Medicine, Seoul National University Bundang Hospital and Medical College of Seoul National University, Seongnam, South Korea;w. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan;x. Department of Orthopedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA;y. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan;z. Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;11. Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan;22. Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China |
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| Abstract: | ![]()
BackgroundTotal hip arthroplasty (THA) involving shortening osteotomy for patients with Crowe type 3 or 4 dysplasia is a challenging surgical procedure. This study aims to demonstrate that rectangular femoral component use in anatomical reconstructions with THA and transverse shortening osteotomy yields successful results without the use of bone graft or any fixation material at the osteotomy site.MethodsFifty hips from 41 patients were identified retrospectively as per study objectives. All patients were evaluated using the Harris Hip Score and Visual Analog Scale for pain. Complications were reported. Radiological evaluation criteria were then evaluated, including leg length discrepancy, degree of trochanter caudalization and stem subsidence, radiolucent and radiodense lines for both components and bone atrophy or hypertrophy around the stem according to Gruen zones, and the canal fill ratio of the stem.ResultsPostoperative Harris Hip Score was excellent for 68% of patients. No patient had poor results. Complication rate was 32%. One patient had nonunion (2%). The mean postoperative leg length discrepancy was 0.8(±0.6) cm. No patient had a subsidence of more than 5 mm. Radiolucent and radiodense lines were present in up to 34% of patients, and bone atrophy was present in the proximal femur in up to 96% of patients. No patient had osteolysis or loosening in neither component.ConclusionSuccessful clinical and radiological results can be obtained from Crowe type 3 and 4 dysplastic hips operated on with THA using a rectangular femoral component and transverse shortening osteotomy technique. The use of graft or any fixation material at the osteotomy site is not mandatory. |
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| Keywords: | developmental hip dysplasia transverse osteotomy cementless rectangular femoral stem zweymuller |
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