The clinical effect of trochanteric slide osteotomy combined with a cementless femoral conical stem in total hip replacement for the treatment of Crowe type IV developmental dysplasia of the hip

Article type: Research Article

Authors: Mo, Ting-Ting¹ | Zhu, Yun-Sen¹ | Zhang, Jiang-Nan | Zhang, Wei-Kang | Jiang, Chang^*

Affiliations: Department of Arthroplasty, First People’s Hospital of Wenling, Wenling, Zhejiang, China

Correspondence: [*] Corresponding author: Chang Jiang, Department of Arthroplasty, First People’s Hospital of Wenling, No. 333 Chuan’an South Road, Wenling, Zhejiang 317500, China. E-mail: [email protected].

Note: [1] These authors contributed equally to this article.

Abstract: BACKGROUND: Total hip replacement (THR) for Crowe type IV developmental dysplasia of the hip (DDH) is still challenging due to specific joint deformities and the high incidence of post-operative complications. OBJECTIVE: This study aimed to evaluate the clinical effect of trochanteric slide osteotomy (TSO) combined with a cementless femoral conical stem in THR for the treatment of Crowe type IV DDH. METHODS: Thirty-one total hip replacements (26 patients) with Crowe type IV DDH were performed using TSO combined with a cementless femoral conical stem. Surgical outcomes were evaluated using leg length discrepancy (LLD), Harris hip score, and post-operative complications. RESULTS: The average pre-operative LLD was 51 mm (range 46–58 mm), decreasing to an average of 10 mm (range 8–12 mm) post-operatively. As a result, the post-operative incidence of the Trendelenburg sign significantly decreased compared with the pre-operative incidence (P< 0.05). Bony union was identified in 26 hips (83.9%), fibrous union in four (12.9%), and non-union in one (3.2%). No acetabular or femoral component loosening, dislocation, or deep infection around the component was found in any of the patients during the follow-up period (27 to 39 months). The average Harris hip score improved from 63.0 ± 3.0 (range 58–69) to 93.3 ± 2.0 (range 91–96). CONCLUSION: TSO combined with a cementless conical stem in THR is an appropriate option for patients with high congenital hip dislocation.

Keywords: Hip dysplasia, hip replacement, greater trochanter, slide osteotomy, conical stem

DOI: 10.3233/THC-220147

Journal: Technology and Health Care, vol. 31, no. 2, pp. 553-563, 2023