Surgical dislocation of the hip without trochanteric osteotomy for the treatment of bone tumors around the hip.

Abstract

Purpose: Bone tumors around the hip pose significant surgical challenges. While surgical dislocation with a trochanteric flip osteotomy through a posterior approach is commonly used, it is associated with known complications. This study is the first to report outcomes using surgical hip dislocation without a trochanteric osteotomy for this purpose. We evaluated early to long-term outcomes of this approach and compared results between patients undergoing extensive curettage with adjuvants and those undergoing simple excision.

Methods: Sixteen patients (18 hips) with benign or intermediate bone and synovial tumors were treated using surgical dislocation without a trochanteric flip osteotomy. Patients had a minimum follow-up of 12 months (median 3.6 years, range 1-11 years). Outcomes included local recurrence, complications, functionality, and quality of life (QoL) assessed with SF-12 (mental and physical components), HOOS, TESS, and MSTS scores. Comparative analysis was performed between extensive curettage with adjuvancy and simple excision. Results All procedures were completed successfully without any local recurrences or significant complications. Patients had a median hospital stay of 3 days (ranging from 1 to 4 days), and the median follow-up duration was 3.6 years (ranging from 1 to 13 years). The mean SF-12 physical and mental health scores were 51 and 42, respectively. Additionally, the scores for HOOS, MSTS, and TESS were 74, 77%, and 86%, respectively. One patient (6%) developed osteoarthritis, while three (17%) experienced lateral hip pain managed conservatively. No significant differences were found in complications, functionality, or QoL between the extensive curettage and simple excision groups.

Conclusion: Surgical dislocation of the hip without trochanteric osteotomy is a safe and effective alternative for excising tumors around the hip. It provides excellent exposure and achieves successful oncologic and functional outcomes. Patients requiring extensive curettage with adjuvants achieve comparable results to those treated with simple excision, offering a viable and novel surgical option for challenging cases.