A new technique of subtrochanteric shortening in total hip arthroplasty

Bruce, Warwick; Rizkallah, Sherif M.; Kwon, Young‐Min; Goldberg, J.; Walsh, William R.

doi:10.1054/arth.2000.4335

Cited by 92 publications

(84 citation statements)

References 27 publications

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“…Reported rates of using cementless stems in dysplastic femora are as high as 20% [3,22,24,28]. Paavilainen et al recommended prophylactic splitting of the proximal femoral shaft [26] and in poor-quality bone, Bruce et al [3] recommended using cement.…”

Section: Discussionmentioning

confidence: 99%

Cemented Total Hip Arthroplasty With Subtrochanteric Osteotomy in Dysplastic Hips

Howie

Ohly

Miller

2010

Clinical Orthopaedics &Amp; Related Research

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Background Total hip arthroplasty (THA) in the presence of developmental dysplasia of the hip (DDH) can be technically challenging. Restoring the anatomic center of hip rotation may require femoral osteotomy. Techniques using cementless components are widely reported but less is known about using cemented components that may be more appropriate with osteopenic bone. Questions/purposes We therefore determined the rate of union, complications, and early functional score in a series of patients with DDH who underwent cemented THA and simultaneous subtrochanteric osteotomy. Methods We retrospectively reviewed 28 patients (35 hips) who underwent a cemented THA for DDH at a mean age of 47.3 years. Two patients (two hips) died within 12 months of surgery of unrelated conditions. The clinical notes and radiographs were reviewed with a minimum followup of 2 years (mean, 5.6 years; range, 2-14 years). Complications were noted. SF-12 and Oxford hip scores (OHS) were recorded for 18 patients preoperatively and after 6 and 12 months. Results Union occurred in 32 of 33 femora (97%); one patient had an infected nonunion. The overall revision rate was 20% (9% femoral revision rate). There were three dislocations, two of which had further surgery. Two patients had a transient neuropraxia. The mean SF-12 physical component score increased from 32 to 52 and mean SF-12 mental component score increased from 48 to 51. The mean OHS decreased from 40 to 27. Conclusion Combined subtrochanteric osteotomy and cemented THA is technically demanding with a higher complication rate than routine THA. The rate of union, complications, implant survival, and early OHS were comparable to those for similar techniques using cementless components.

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Section: Discussionmentioning

confidence: 99%

Cemented Total Hip Arthroplasty With Subtrochanteric Osteotomy in Dysplastic Hips

Howie

Ohly

Miller

2010

Clinical Orthopaedics &Amp; Related Research

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“…at the proximal end of the femur makes our approach different from other approaches and techniques because other approaches divide the femur in two parts (either at the subtrochanteric level or trochanteric level) [2,3,12,13,15]. The patient can be placed in either the supine or lateral decubitus position.…”

Section: Methodsmentioning

confidence: 99%

“…For patients with high dislocation from developmental dysplasia, for revision hip surgery, and for patients with proximal femoral deformities, special procedures and approaches must be used [2,3,14,15]. These approaches must provide good exposure while allowing extremity length equalization, proximal femoral shortening, anatomic cup placement, and soft tissue balance [3,4,12,14,17].…”

Section: Introductionmentioning

confidence: 99%

Femoral Shortening During Hip Arthroplasty Through a Modified Lateral Approach

Delimar

Bićanić

Koržinek

2008

Clin Orthop Relat Res

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We describe a modification of the direct lateral approach to the hip that provides excellent femoral and acetabular exposure and an easy way to shorten the proximal femur and equalize leg length. The approach also is useful for lower extremity elongation while preserving muscle continuity and minimizing postoperative complications. The exact amount of shortening can be calculated and planned preoperatively and measured and corrected intraoperatively if necessary. It avoids the necessity for osteotomies of the trochanter and transverse cuts or detachment of abductor muscles.

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“…В большинстве исследований отмечается, что консолидация в зоне остеотомии была достигнута в срок от 12 нед. до 1 года [4, 6-8, 22,24,26,27,29]. однако частота несращений была также высока.…”

Section: материал и методыunclassified

“…Многие ортопеды придают большое значение способу обработки торцевых поверхностей, вы-полняя косую или ступенчатую (step-cut) остео-томию для увеличения стабильности фиксации в зоне остеотомии, считая, что от этого зависит длительность консолидации фрагментов и успех лечения в целом [8, 20,22,[24][25][26]29]. однако вы-полнение косой и step-cut остеотомии достаточно трудоемко и увеличивает объем интраоперацион-ной кровопотери и продолжительность операции в целом [22].…”

Section: материал и методыunclassified

Features of Tha in Patients With High Congenital Hip Dislocation

Камшилов

Triapichnikov

Чегуров

et al. 2017

Traumatology and Orthopedics of Russia

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There are a fair number of papers presenting the outcomes of total hip arthroplasty with shortening subtrochanteric osteotomy in neglected hip dislocation. In most of them the authors used long modular stems or Wagner stems as a femoral component. The reports describing the outcomes of such procedures with standard femoral stems are rather rare.The purpose of this study was to evaluate short-term and medium-term outcomes of total hip arthroplasty with standard femoral stems and shortening subtrochanteric osteotomy for treatment of high hip dislocation.Materials and methods. From 2010 to 2016 the authors performed 18 hip arthroplasties with shortening subtrochanteric osteotomy in 16 patients with high hip dislocation. All patients were clinically evaluated using Harris Hip Score and radiography prior to and after the surgery.Results. The mean Harris Hip Score significantly improved compared to preoperative values from 39.7±1.4 to 84.7±1.6. At mean follow-up of 24±2.4 mounts the authors observed 2 case of nonunion at osteotomy site and 1 case of transient nerve palsy. Revision surgery was performed in 2 patients due to nonunion. The mean limb lengthening was 3.65±0.21 cm.Conclusion. Our data demonstrated that total hip arthroplasty with subtrochanteric osteotomy is an effective technique for treatment of Crowe type III-IV congenital hipdislocation with high rate of successful fixation on the typical femoral stem, healing of osteotomy site and satisfactory shortand medium-term clinical outcomes. The non-modular tapered stem provides sufficient stability in distal and proximal parts of the femur. The use of standard tapered stem allows to achieve good healing rates of the osteotomy.

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A new technique of subtrochanteric shortening in total hip arthroplasty

Cited by 92 publications

References 27 publications

Cemented Total Hip Arthroplasty With Subtrochanteric Osteotomy in Dysplastic Hips

Cemented Total Hip Arthroplasty With Subtrochanteric Osteotomy in Dysplastic Hips

Femoral Shortening During Hip Arthroplasty Through a Modified Lateral Approach

Features of Tha in Patients With High Congenital Hip Dislocation

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