A COMPARATIVE STUDY ON TWO OSTEOTOMIES IN TOTAL HIP ARTHROPLASTY FOR CROWE TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANGXucheng , LEIPengfei , WENTing ,  HUYihe

Department of Orthopedics, Xiangya Hospital, Central South University, Changsha Hunan, 410008, P. R. China;

Corresponding author：

HUYihe, Email: huyh1964@163.com

Keywords：

Developmental dysplasia of the hip; Total hip arthroplasty; Trochanteric osteotomy; Subtrochanteric osteotomy

DOI：

10.7507/1002-1892.20150095

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To assess the effectiveness of two osteotomy methods in total hip arthroplasty (THA) for treating Crowe type ⅠV adult developmental dysplasia of the hip (DDH), trochanteric osteotomy and subtrochanteric osteotomy. Methods A retrospective analysis was made on the clinical data of 36 patients (43 hips) with Crowe type ⅠV DDH undergoing THA between June 2007 and December 2013. In THA, 19 patients (23 hips) underwent trochanteric osteotomy (group A) and 17 patients (20 hips) underwent subtrochanteric osteotomy (group B). There was no significant difference in age, gender, body mass index, side, preoperative Harris score, and limb length difference between 2 groups (P>0.05). The operation duration, bleeding volume, hospitalization duration, intraoperative and postoperative complications were compared between 2 groups. Results There was no significant difference in operation duration, bleeding volume, and hospitalization days between 2 groups (P>0.05). The rate of intraoperative complication was 21.7% (5/23) in group A and 5.0% (1/20) in group B, showing no significant difference between 2 groups (P>0.05). The rate of postoperative complications was 10.5% (2/19) in group A and 22.2% (4/18) in group B, showing no significant difference between 2 groups (P>0.05). Thirty-one patients (37 hips) were followed up 1-7 years (mean, 3 years), including 16 cases (19 hips) in group A and 15 cases (18 hips) in group B. X-ray films showed good position of the prostheses. The Harris score at last follow-up was significantly increased when compared with preoperative score in 2 groups (P<0.05), but there was no significant difference between 2 groups (P>0.05). The postoperative discrepancy of bilateral lower limbs had no significant difference (t=-1.343, P=0.188). Conclusion THA with trochanteric osteotomy or subtrochanteric osteotomy both can effectively treat Crowe type ⅠV DDH. THA with subtrochanteric osteotomy has an advantage in correcting lower limb discrepancy.

Citation： YANGXucheng, LEIPengfei, WENTing, HUYihe. A COMPARATIVE STUDY ON TWO OSTEOTOMIES IN TOTAL HIP ARTHROPLASTY FOR CROWE TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 439-443. doi: 10.7507/1002-1892.20150095 Copy

1.	Kilişoğlu OI, Türker M, Akgül T, et al. Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type ⅠV congenital hip dislocation. J Arthroplasty, 2013, 28(1):117-125.
2.	Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type Ⅳ developmental dysplasia. J Arthroplasty, 2012, 27(9):1629-1635.
3.	Xu H, Zhou Y, Liu Q, et al. Femoral morphologic differences in subtypes of high developmental dislocation of the hip. Clin Orthop Relat Res, 2010, 468(12):3371-3376.
4.	Lai KA, Shen WJ, Huang LW, et al. Cementless total hip arthroplasty and limb-length equalization in patients with unilateral Crowe type-IV hip dislocation. J Bone Joint Surg (Am), 2005, 87(2):339-345.
5.	Sağlam N, Sener N, Beksac B, et al. Total hip arthroplasty and problems encountered in patients with high-riding developmental dysplasia of the hip. Acta Orthop Traumatol Turc, 2002, 36(3):187-194.
6.	Eskelinen A, Helenius I, Remes V, et al. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone Joint Surg (Am), 2006, 88(1):80-91.
7.	Adamany DC, Politi JR, Hauser WH. S-ROM hip prosthesis:10- to 14-year results. Orthopedics, 2008, 31(3):220.
8.	Fujishiro T, Nishiyama T, Hayashi S, et al. Leg length change in total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe type ⅠV developmental hip dysplasia. J Arthroplasty, 2012, 27(6):1019-1022.
9.	周勇刚, 张强, 王岩, 等. 两种不同截骨方法治疗Crowe IV型先天性髋脱位的比较研究. 中华外科杂志, 2008, 46(17):1288-1292.
10.	Nakahara I, Takao M, Sakai T, et al. Three-dimensional morphology and bony range of movement in hip joints in patients with hip dysplasia. Bone Joint J, 2014, 96-B(5):580-589.
11.	Hartofilakidis G, Yiannakopoulos CK, Babis GC. The morphologic variations of low and high hip dislocation. Clin Orthop Relat Res, 2008, 466(4):820-824.
12.	Imbuldeniya AM, Walter WL, Zicat BA, et al. Cementless total hip replacement without femoral osteotomy in patients with severe developmental dysplasia of the hip:minimum 15-year clinical and radiological results. Bone Joint J, 2014, 96-B(11):1449-1454.
13.	Biant L C, Bruce WJ, Assini JB, et al. Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem. J Arthroplasty, 2009, 24(1):27-32.
14.	Onodera S, Majima T, Ito H, et al. Cementless total hip arthroplasty using the modular S-ROM prosthesis combined with corrective proximal femoral osteotomy. J Arthroplasty, 2006, 21(5):664-669.
15.	Mattingly DA. The S-rOM modular femoral stem in dysplasia of the hip. Orthopedics, 2005, 28(9 Suppl):s1069-s1073.
16.	Bao N, Meng J, Zhou L, et al. Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type ⅠV developmental dysplasia of hip. Int Orthop, 2013, 37(3):385-390.
17.	Lei P, Hu Y, Cai P, et al. Greater trochanter osteotomy with cementless THA for Crowe type ⅠV DDH. Orthopedics, 2013, 36(5):e601-e605.
18.	Hartofilakidis G, Babis GC, Georgiades G, et al. Trochanteric osteotomy in total hip replacement for congenital hip disease. J Bone Joint Surg (Br), 2011, 93(5):601-607.
19.	Thorup B, Mechlenburg I, Søballe K. Total hip replacement in the congenitally dislocated hip using the Paavilainen technique:19 hips followed for 1.5-10 years. Acta Orthop, 2009, 80(3):259-262.
20.	Togrul E, Ozkan C, Kalaci A, et al. A new technique of subtrochanteric shortening in total hip replacement for Crowe type 3 to 4 dysplasia of the hip. J Arthroplasty, 2010, 25(3):465-470.
21.	Krych AJ, Howard JL, Trousdale RT, et al. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia:surgical technique. J Bone Joint Surg (Am), 2010, 92 Suppl 1 Pt 2:176-187.

1. Kilişoğlu OI, Türker M, Akgül T, et al. Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type ⅠV congenital hip dislocation. J Arthroplasty, 2013, 28(1):117-125.
2. Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type Ⅳ developmental dysplasia. J Arthroplasty, 2012, 27(9):1629-1635.
3. Xu H, Zhou Y, Liu Q, et al. Femoral morphologic differences in subtypes of high developmental dislocation of the hip. Clin Orthop Relat Res, 2010, 468(12):3371-3376.
4. Lai KA, Shen WJ, Huang LW, et al. Cementless total hip arthroplasty and limb-length equalization in patients with unilateral Crowe type-IV hip dislocation. J Bone Joint Surg (Am), 2005, 87(2):339-345.
5. Sağlam N, Sener N, Beksac B, et al. Total hip arthroplasty and problems encountered in patients with high-riding developmental dysplasia of the hip. Acta Orthop Traumatol Turc, 2002, 36(3):187-194.
6. Eskelinen A, Helenius I, Remes V, et al. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone Joint Surg (Am), 2006, 88(1):80-91.
7. Adamany DC, Politi JR, Hauser WH. S-ROM hip prosthesis:10- to 14-year results. Orthopedics, 2008, 31(3):220.
8. Fujishiro T, Nishiyama T, Hayashi S, et al. Leg length change in total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe type ⅠV developmental hip dysplasia. J Arthroplasty, 2012, 27(6):1019-1022.
9. 周勇刚, 张强, 王岩, 等. 两种不同截骨方法治疗Crowe IV型先天性髋脱位的比较研究. 中华外科杂志, 2008, 46(17):1288-1292.
10. Nakahara I, Takao M, Sakai T, et al. Three-dimensional morphology and bony range of movement in hip joints in patients with hip dysplasia. Bone Joint J, 2014, 96-B(5):580-589.
11. Hartofilakidis G, Yiannakopoulos CK, Babis GC. The morphologic variations of low and high hip dislocation. Clin Orthop Relat Res, 2008, 466(4):820-824.
12. Imbuldeniya AM, Walter WL, Zicat BA, et al. Cementless total hip replacement without femoral osteotomy in patients with severe developmental dysplasia of the hip:minimum 15-year clinical and radiological results. Bone Joint J, 2014, 96-B(11):1449-1454.
13. Biant L C, Bruce WJ, Assini JB, et al. Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem. J Arthroplasty, 2009, 24(1):27-32.
14. Onodera S, Majima T, Ito H, et al. Cementless total hip arthroplasty using the modular S-ROM prosthesis combined with corrective proximal femoral osteotomy. J Arthroplasty, 2006, 21(5):664-669.
15. Mattingly DA. The S-rOM modular femoral stem in dysplasia of the hip. Orthopedics, 2005, 28(9 Suppl):s1069-s1073.
16. Bao N, Meng J, Zhou L, et al. Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type ⅠV developmental dysplasia of hip. Int Orthop, 2013, 37(3):385-390.
17. Lei P, Hu Y, Cai P, et al. Greater trochanter osteotomy with cementless THA for Crowe type ⅠV DDH. Orthopedics, 2013, 36(5):e601-e605.
18. Hartofilakidis G, Babis GC, Georgiades G, et al. Trochanteric osteotomy in total hip replacement for congenital hip disease. J Bone Joint Surg (Br), 2011, 93(5):601-607.
19. Thorup B, Mechlenburg I, Søballe K. Total hip replacement in the congenitally dislocated hip using the Paavilainen technique:19 hips followed for 1.5-10 years. Acta Orthop, 2009, 80(3):259-262.
20. Togrul E, Ozkan C, Kalaci A, et al. A new technique of subtrochanteric shortening in total hip replacement for Crowe type 3 to 4 dysplasia of the hip. J Arthroplasty, 2010, 25(3):465-470.
21. Krych AJ, Howard JL, Trousdale RT, et al. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia:surgical technique. J Bone Joint Surg (Am), 2010, 92 Suppl 1 Pt 2:176-187.

Chinese Journal of Reparative and Reconstructive Surgery

A COMPARATIVE STUDY ON TWO OSTEOTOMIES IN TOTAL HIP ARTHROPLASTY FOR CROWE TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content