Mid-term results of total hip arthroplasty with subtrochanteric Z-osteotomy in Crowe type 3-4 developmental hip dysplasia
| Autor: | Izzet Bingol, Tamer Sazak, Vedat Biçici |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty subtrochanteric femoral shortening osteotomy Visual analogue scale Developmental dislocation of the hip medicine.medical_treatment Arthroplasty Replacement Hip osteotomy fixation Osteotomy Article medicine Humans Femur Hip Dislocation Congenital Retrospective Studies Hip dysplasia Palsy business.industry General Medicine Middle Aged medicine.disease Surgery total hip replacement Dissection Harris Hip Score Developmental Dysplasia of the Hip Female Sciatic nerve business Complication Follow-Up Studies |
| Zdroj: | Turkish Journal of Medical Sciences |
| ISSN: | 1303-6165 1300-0144 |
| Popis: | Background/aim Total hip arthroplasty (THA) is technically more difficult and has higher complication rates in patients with Crowe type 3–4 developmental dysplasia of the hip (DDH). Due to the difficulties and different treatment options, there is still no consensus on the optimal treatment. We aimed to evaluate the mid-term results of our patients who had undergone subtrochanteric femoral shortening Z-osteotomy. Materials and methods This study included 37 hips of 29 patients with the diagnosis of Crowe 3-4 DDH between June 2010 and December 2016 and who underwent femoral shortening Z-osteotomy with cementless total hip arthroplasty. Acetabular component was determined according to the patient’s age and functional capacity and all patients were operated with a posterior approach. Functional results, postoperative complications, Harris and visual analogue scale (VAS) scores were evaluated. Results The average Harris hip score was 41.3 ± 3.1 preoperatively and 84.7 ± 4.3 postoperatively (p < 0.05). The mean preoperative hip pain score on the VAS was 7.9 (range: 6–9) and this was significantly lower at the last follow-up (mean: 3.4; range: 2–4) (p < 0.05). The final mean limb-length discrepancy was 1.3 cm. The average amount of femoral shortening was 3.2 cm. Regarding complications, 3 (10.3%) patients had dislocations. These patients underwent closed reduction. Sciatic palsy developed in 1 (3.4%) patient. The patient was reoperated on for sciatic nerve dissection in the early period. Conclusion Subtrochanteric shortening Z-osteotomy combined with cementless total hip replacement can be considered an effective and successful method in selected patients with Crowe 3-4 coxarthrosis. |
| Databáze: | OpenAIRE |
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