Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 1/2021

08.11.2020 | Hip Arthroplasty

Level of osteotomy is relevant to obtain better union and clinical results in patients with severe hip dysplasia operated on with total hip arthroplasty and shortening osteotomy using a cementless, rectangular femoral component

verfasst von: Mahmut Enes Kayaalp, Ata Can, Fahri Erdogan, Mahmut Kursat Ozsahin, Onder Aydingoz, Gokhan Kaynak

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction and objective

Total hip arthroplasty with rectangular femoral component and transverse osteotomy for patients with Crowe type 3 or 4 dysplasia yields successful results with varying radiological findings. This study aims to investigate the surgery and patient related factors associated with successful clinical and radiological results.

Patients and methods

Fifty hips of 41 patients were retrospectively examined. Length and percentage of the stem passing the osteotomy level and canal fill ratio were measured. Radiological findings such as radiolucent lines (RL) around the stem, hypertrophic callus or an identifiable osteotomy line on X-ray images were assessed. All clinical and radiological results were analyzed for any significant association.

Results

Mean stem length and percentage passing the osteotomy level were 6.4 cm (± 0.7) and 51% (± 6). Presence of an identifiable osteotomy line was positively associated with the increasing length of the stem passing the osteotomy level and with a lower HHS (p < 0.05). RL around the stem were associated with a lesser reduction in VAS score (p < 0.05).

Conclusion

Rectangular femoral stem conveniently accommodate the proximal femur in severely dysplastic hips. An upper limit for the femoral stem exists to obtain better bony union and higher HHS. RL around the stem are clinically relevant and is associated with a worse VAS score at the latest follow-up.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
2.
Zurück zum Zitat Perka C, Fischer U, Taylor WR, Matziolis G (2004) Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup. J Bone Joint Surg Am 86(2):312–319CrossRef Perka C, Fischer U, Taylor WR, Matziolis G (2004) Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup. J Bone Joint Surg Am 86(2):312–319CrossRef
3.
Zurück zum Zitat Gotze C, Winkelmann W, Gosheger G, Rodl R (2007) Is there a need of an additional extramedullary fixation in transverse subtrochanteric shortening in primary total hip arthroplasty for patients with severe hip dysplasia? Short-term experience in seven patients with congenital dislocation. Z Orthop Unfall 145(5):568–573. https://doi.org/10.1055/s-2007-965615CrossRefPubMed Gotze C, Winkelmann W, Gosheger G, Rodl R (2007) Is there a need of an additional extramedullary fixation in transverse subtrochanteric shortening in primary total hip arthroplasty for patients with severe hip dysplasia? Short-term experience in seven patients with congenital dislocation. Z Orthop Unfall 145(5):568–573. https://​doi.​org/​10.​1055/​s-2007-965615CrossRefPubMed
6.
7.
Zurück zum Zitat Gotze C, Steens W, Vieth V, Poremba C, Claes L, Steinbeck J (2002) Primary stability in cementless femoral stems: custom-made versus conventional femoral prosthesis. Clin Biomech (Bristol, Avon) 17(4):267–273CrossRef Gotze C, Steens W, Vieth V, Poremba C, Claes L, Steinbeck J (2002) Primary stability in cementless femoral stems: custom-made versus conventional femoral prosthesis. Clin Biomech (Bristol, Avon) 17(4):267–273CrossRef
11.
Zurück zum Zitat Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res 235:148–165 Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res 235:148–165
12.
Zurück zum Zitat Liu S, Zuo J, Li Z, Yang Y, Liu T, Xiao J, Gao Z (2017) Study of three-dimensional morphology of the proximal femur in developmental adult dysplasia of the hip suggests that the on-shelf modular prosthesis may not be an ideal choice for patients with Crowe type IV hips. Int Orthop 41(4):707–713. https://doi.org/10.1007/s00264-016-3248-6CrossRefPubMed Liu S, Zuo J, Li Z, Yang Y, Liu T, Xiao J, Gao Z (2017) Study of three-dimensional morphology of the proximal femur in developmental adult dysplasia of the hip suggests that the on-shelf modular prosthesis may not be an ideal choice for patients with Crowe type IV hips. Int Orthop 41(4):707–713. https://​doi.​org/​10.​1007/​s00264-016-3248-6CrossRefPubMed
26.
Zurück zum Zitat Rubin PJ, Leyvraz PF, Aubaniac JM, Argenson JN, Esteve P, de Roguin B (1992) The morphology of the proximal femur. A three-dimensional radiographic analysis. J Bone Joint Surg Br 74(1):28–32CrossRef Rubin PJ, Leyvraz PF, Aubaniac JM, Argenson JN, Esteve P, de Roguin B (1992) The morphology of the proximal femur. A three-dimensional radiographic analysis. J Bone Joint Surg Br 74(1):28–32CrossRef
Metadaten
Titel
Level of osteotomy is relevant to obtain better union and clinical results in patients with severe hip dysplasia operated on with total hip arthroplasty and shortening osteotomy using a cementless, rectangular femoral component
verfasst von
Mahmut Enes Kayaalp
Ata Can
Fahri Erdogan
Mahmut Kursat Ozsahin
Onder Aydingoz
Gokhan Kaynak
Publikationsdatum
08.11.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 1/2021
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-020-03659-1

Weitere Artikel der Ausgabe 1/2021

Archives of Orthopaedic and Trauma Surgery 1/2021 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.