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A Reliable Femoral Osteotomy in Total Hip Arthroplasty for Hartofilakidis Type C Developmental Dysplasia of the Hip: Proximal Femoral Reconstruction
Affiliation:1. Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT;2. Department of Orthopaedic Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA;1. Board Member-At-Large, American Association of Hip and Knee Surgeons University of Virginia, USA;2. Member, Hip Society, Rush University Medical Center, USA;3. Member, Knee Society, Stanford University, USA;4. President, American Association of Hip and Knee Surgeons Rush University Medical Center, USA
Abstract:
BackgroundProcedure of the femur is extremely challenging during total hip arthroplasty (THA) for Hartofilakidis type C developmental dysplasia of the hip. The main purpose of this study is to compare the clinical effectiveness of proximal femoral reconstruction (PFR) with subtrochanteric transverse osteotomy (STO).MethodsBetween 2006 and 2015, 33 primary THAs in 26 patients were performed with PFR and 16 hips in 13 patients underwent STO. The mean follow-up was 4.2 (range, 2.2-10.8) years in PFR group and 5.9 (range, 3.5-11.3) years in STO group. At the final follow-up, clinical scores and radiographic results were evaluated for 33 hips in PFR group and 15 hips in STO group.ResultsPostoperative Harris hip scores and implant position did not differ between the treatment groups. The mean length of the oblique osteotomy line at proximal femur was 6.9 cm (range, 5.8-7.6 cm) in PFR group. The amount of bone union occurred within 6 months after surgery was 24 (72.7%) hips in PFR group and 9 (60.0%) in STO group. Three major postoperative complications occurred in PFR group, and medial femoral calcar erosion was noted in 1 hip in STO group.ConclusionSimilar with STO, the clinical results of PFR technique are a reliable solution for femoral procedure during THA in patients with Hartofilakidis type C developmental dysplasia of the hip.
Keywords:total hip arthroplasty  hip dysplasia  high hip dislocation  reconstruction  osteotomy
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