Cementless total hip arthroplasty with a double chevron subtrochanteric shortening osteotomy in patients with Crowe type-IV hip dysplasia


Published online: Jun 27 2013

Xigong LI, Junying SUN, Xiangjin LIN, Sanzhong XU, Tiansi TANG

From the First Affiliated Hospitals of Zhejiang University, Hangzhou, China and of Suzhou University, Suzhou, China

Abstract

The authors describe a modified double chevron subtrochanteric shortening osteotomy combined with cementless total hip arthroplasty for Crowe type-IV hip dysplasia. Shortening the femur allows to relax the shortened musculature. This operation was performed in 18 patients (22 hips) between January 2000 and February 2006. The mean follow-up period was 5.6 years (range : 3 to 8 years). The mean amount of femoral subtrochanteric shortening was 38 mm (range : 25 to 60 mm). The mean Harris hip score improved from 47 (range : 35 to 65) preoperatively to 88 points (range : 75 to 97) at final follow-up. The Trendelenburg sign was corrected from positive to negative in 12 of 22 hips. No acetabular or femoral components loosened or required revision during the follow-up period. All osteotomy sites healed in 3 to 6 months without complications. Cementless total hip arthroplasty using the modified double chevron subtrochanteric osteotomy provided good short- to midterm results in all 22 Crowe type-IV hip dislocations.Moreover, it restored the anatomic hip center and the limb length, which contributed to correction of the preoperative limp.