Total Hip Arthroplasty With Femoral Osteotomy for Proximal Femoral Deformity

Cemented Total Hip Arthroplasty With Subtrochanteric Osteotomy in Dysplastic Hips

“…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.…”

“…THA with subtrochanteric osteotomy is an infrequently performed procedure (0.1%-0.3% of all THAs at the Mayo Clinic [19,28]), and even in specialist centers, it is associated with increased complication rates ( Table 1). Ours is a relatively large series of cemented THA with subtrochanteric osteotomy and suggests the rate of union, complications, and revision rate using this technique are comparable to those for cementless techniques.…”

“…During acetabular reconstruction of the dysplastic adult hip, it is acknowledged that the anatomic center of hip rotation should be restored [20,27,36], although the difficulties in identifying and preparing the true acetabulum and achieving stable fixation of the acetabular component are well described [7,10,13,16,28]. On the femoral side, there are further technical challenges, including excessive femoral neck anteversion resulting in a posterior position of the greater trochanter and chronic shortening of the surrounding soft tissue structures.…”

Untreated congenital and posttraumatic high dislocation of the hip treated by replacement in adult age22 hips in 16 patients followed for 18 years

“…It has been recommended after Schantz osteotomies. However, this type of osteotomy seems to heal slowly and revision surgery for nonunion may be necessary (Paavilainen et al 1990, Papagelopoulos et al 1996. Femoral osteotomy has also been performed as a square subtrocanteric resection (Bruce et al 2000) or as a double-chevron subtrochanteric osteotomy (Becker and Gustilo 1995).…”

Hip Arthroplasty in Highly Dislocated Hips

“…One technique involves resection of a larger part of the trochanter mass, hence the entire metaphysis and a portion of diaphysis, with preservation of the great trochanter with abductor attachments, while by other operative procedures resection osteotomy is performed only on the diaphysis below the small trochanter, with the metaphysis remaining preserved. Femoral abbreviation osteotomies in total arthroplasty of the hip, particularly when treating high luxations due to DDH, have been described by numerous authors (Dunn et al, 1976;Crowe et al, 1979 ;Paavilainen at al., 1990Paavilainen at al., , 1993Hartofilakidis et al, 1996Hartofilakidis et al, , 1998Hartofilakidis et al, , 2004Hartofilakidis et al, , 2008Papagelopoulos et al, 1996;Numair et al, 1997;Carrlson et al, 2003). The original operative technique by Paavilainen et al has been slightly modified by Carlsson et al, but basic postulates have remained the same.…”