The Outcome of Total Hip Arthroplasty Without Subtrochanteric Shortening Osteotomy in Severe Developmental Dysplasia of the Hip

AuthorMohammad Kazem Emami Meybodien
AuthorShahram Shirvanien
AuthorMorteza Jannesari Ladanien
AuthorSajjad Mohammadnabien
AuthorMohammad Mahdi Shateren
OrcidMohammad Kazem Emami Meybodi [0000-0003-3862-5172]en
OrcidShahram Shirvani [0000-0002-7539-8653]en
OrcidMorteza Jannesari Ladani [0000-0001-6218-2645]en
OrcidSajjad Mohammadnabi [0000-0002-2912-5427]en
OrcidMohammad Mahdi Shater [0000-0002-3248-3751]en
Issued Date2024-02-29en
AbstractBackground: Total hip arthroplasty (THA) is a surgical technique to correct developmental dysplasia of the hip (DDH). Various THA-based methods have been developed for managing end-stage osteoarthritis in patients with DDH Crowe type III or IV. Objectives: In this study, we evaluate the Harris hip score (HHS) before and after cementless THA without subtrochanteric shortening osteotomy (STO) in patients with DDH Crowe type III or IV who were candidates for THA, as well as complications and the need for revision surgery. Methods: This retrospective cohort study was conducted on patients with DDH Crowe type III and IV, who were candidates for cementless THA using the Watson Jones technique without shortening STO. The HHS was calculated and recorded in their medical files before surgery. Patients with missing or incomplete medical files, without written informed consent, with neurovascular diseases, immunosuppressive drug use, congenital bone and articular anomalies, low back pain radiating to the lower extremities, simultaneous fractures, a history of lower extremity fractures, or joint infections were excluded. The HHS was recalculated during outpatient follow-up. Neurovascular defects and the need for reoperation were also evaluated. All data were recorded and analyzed. Results: Thirty-two patients were enrolled with a mean ± SD age of 50.34 ± 15.45 years, most of whom were women (75%). The patients were followed for 2 to 7 years. Postoperative nerve defects were observed in only 1 (3.1%) patient. Hip reoperation was performed in 1 (3.1%) patient. The mean ± SD of HHS before surgery was 50.10 ± 12.48, which increased significantly to 77.99 ± 15.60 after surgery (P < 0.001). Furthermore, the HHS was evaluated before and after the intervention for each gender, showing a significant increase in both. Conclusions: Cementless THA without shortening osteotomy can improve HHS in patients with DDH Crowe III and IV, providing satisfactory outcomes. Furthermore, complications, such as neurological defects and the need for reoperation, are minimal with this method.en
DOIhttps://doi.org/10.5812/semj-139738en
KeywordTotal Hip Arthroplastyen
KeywordDevelopmental Dysplasia of the Hipen
KeywordTotal Hip Replacementsen
KeywordSubtrochanteric Shortening Osteotomyen
KeywordLevel of Evidence: IIIen
PublisherBrieflandsen
TitleThe Outcome of Total Hip Arthroplasty Without Subtrochanteric Shortening Osteotomy in Severe Developmental Dysplasia of the Hipen
TypeResearch Articleen

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