Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmental dysplasia

Introduction The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem. Methods We evaluated radiographs, functional scores and complications in...

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Bibliographic Details
Published in:	European journal of orthopaedic surgery & traumatology Vol. 29; no. 5; pp. 1025 - 1033
Main Authors:	Necas, Libor, Hrubina, Maros, Melisik, Marian, Cibula, Zoltan, Chmurny, Michal, Daniel, Matej, Steno, Boris
Format:	Journal Article
Language:	English
Published:	Paris Springer Paris 01-07-2019 Springer Nature B.V
Subjects:	Adult Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - methods Female Hip Dislocation, Congenital - diagnosis Hip Dislocation, Congenital - surgery Hip Joint - diagnostic imaging Hip Joint - physiopathology Hip Joint - surgery Humans Joint Dislocations - etiology Joint Dislocations - surgery Joint surgery Leg Length Inequality - etiology Leg Length Inequality - surgery Male Medicine Medicine & Public Health Middle Aged Original Article • HIP - ARTHROPLASTY Osteotomy - adverse effects Osteotomy - methods Outcome and Process Assessment, Health Care Patients Postoperative Complications - diagnosis Postoperative Complications - physiopathology Postoperative Complications - surgery Prostheses Radiography - methods Reoperation - adverse effects Reoperation - methods Reoperation - statistics & numerical data Retrospective Studies Surgery Surgical Orthopedics Trauma Traumatic Surgery Hip dysplasia S-ROM stem Shortening femoral osteotomy
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Summary:	Introduction The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem. Methods We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22–68) years. The operations were performed between 2007 and 2013. Patients were assessed retrospectively–clinically and radiographically during the year 2018. Results The mean follow-up period was 94 (range 60–134) months. The average Harris hip score improved from 39.9 to 84.0. The mean leg length discrepancy decreased from 5 cm preoperatively to 1.4 cm at the final follow-up. All acetabular components were implanted into the true acetabulum, and all prostheses were stable at the latest examination. No neurovascular damage was recorded. We have identified specific complications in seven hips (25%) in total: Intraoperative femoral fracture required fixation in four hips; three hips (10.7%) needed revision: Recurrent dislocation, with the need for cup reorientation, occurred in two hips (in one of them, this was followed by the subsequent need for resection of heterotopic ossification); there was one aseptic stem loosening with the need of one-stage revision. All the osteotomies healed within 8 months. Conclusion Hip arthroplasty with transverse shortening femoral osteotomy, using S-ROM stem, is an acceptable, but not complication-free treatment method in patients with Crowe type IV developmental hip dysplasia, in the midterm.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1633-8065 1432-1068
DOI:	10.1007/s00590-019-02400-y