Cementless THA with Femoral Shortening Osteotomy Provides Excellent Results for Patients with Crowe Type IV Hip Dysplasia.

Abstract

Introduction: This study aimed to present the clinical and radiological results and look for complications of total hip arthroplasty (THA) performed with subtrochanteric transverse femoral shortening osteotomy (STFO) for Crowe type IV developmental dysplasia of the hip (DDH).

Material and methods: Ninety-four patients who underwent STFO and THA for Crowe type IV DDH between 2013 and 2018 were retrospectively evaluated. The mean follow-up period of the patients was 40 months (range 25 to 55) and the mean operation time was 58 min (range 52 to 70). We examined the results of routine anteroposterior and lateral hip radio- graphy. The time required for healing of the osteotomy line, preoperative and postoperative Harris Hip Score (HHS), limb length discrepancies, the level of limping and Trendelenburg tests were evaluated for all patients. All complications were noted.

Results: The mean healing time was 5.4 months (range 4 to 10). The preoperative HHS improved from a mean of 52 points (range 42 to 61) to 84 points (range 75 to 96) after the operation (p < 0.001). Only two patients had postoperative positive Trendelenburg tests. There were no cases of nonunion or sciatic nerve palsy. An interoperative femoral fracture was observed in one case.

Conclusions: This study demonstrates that excellent clinical outcomes can be achieved with no revisions, no nonunion, and minimal residual limping in patients who undergo shortening with STFO using a Wagner cone for the femur and a primary cup for the acetabulum.