Original Article
Results on Total Hip Arthroplasties With Femoral Shortening for Crowe's Group IV Dislocated Hips

https://doi.org/10.1016/j.arth.2006.02.157Get rights and content

Abstract

We performed total hip arthroplasties in 11 women with Crowe's group IV completely dislocated hips, with a mean age at surgery of 59.6 years and a mean follow-up of 65 months. In all cases, femoral shortening was achieved using step-cut osteotomy. All acetabular cups were placed in their anatomical locations. The mean Merle d'Aubigne hip score improved from 10.9 points to 16.9. There was no case of nonunion or malunion in the osteotomized site. Temporary numbness was observed in 2 hips, which subsided within 3 weeks without any treatment. One hip had to be revised 8 years after surgery because of aseptic loosening of the stem. Our study shows that total hip arthroplasty, incorporating step-cut femoral shortening, provides acceptable results for completely dislocated hip.

Section snippets

Patients and Methods

Between 1990 and 2002, total hip arthroplasties were performed on 12 adult female patients with Crowe's group IV completely dislocated hips. One patient was lost to follow-up study. The remaining 11 hips of 11 patients were analyzed in this series. The mean age of the patients at surgery was 59.6 years (range, 42-76 years), and the mean follow-up period was 65 months (range, 30-169 months). The main indication for surgery was pain around the hips. Three of the 11 patients had been treated in

Clinical Results

Using the Merle d'Aubigne and Postel system, the unrevised hip was advanced from a mean of 10.9 (range, 7-12) points to 16.9 (range, 15-18) points at the latest follow-up (P < .05). The mean pain score had confirmed recuperation from 2.8 (range, 1-4) points preoperatively to 6 (all 6), the mean mobility score progressed from 5.2 (range, 3-6) points to 5.9 (range, 5-6), and the mean walking score improved from 2.9 (range, 2-4) to 5.0 (range, 3-6) points (Fig. 3).

The Amount of Femoral Resection and Leg Lengthening

The mean amount of intraoperative

Discussion

Russotti and Harris [11] reported that the average horizontal distance of an anatomic hip center in normal hips was 37 mm and the vertical height, 14 mm, whereas Yoder et al [12] reported that they are 42 and 14 mm, respectively. Using 57 female pelvic cadaver specimens with normal hips, John and Fisher [13] found the mean measurements to be 25 and 14 mm. From these data, we can see that in our series, the average location of the postoperative hip center was of normal height and a somewhat

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  • Total hip arthroplasty in the developmental dysplasia of the hip using transverse subtrochanteric osteotomy

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    Percutaneous adductor tenotomy was applied when hip abduction limitation was determined. Femoral shortening can be achieved through proximal, subtrochanteric or distal osteotomies.4,6,7,25,9,28,29 Most authors in the literature discuss the superiority and advantages of their own osteotomy techniques.

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No benefits or funds were received in support of the study.

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