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An alternative treatment method to restore limb-length discrepancy in osteoarthritis with high congenital hip
Matthias Lerch1, F Thorey, G von Lewinski
1Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany. matthias.lerch@annastift.de
Aim:
The purpose of this study was to describe the rationale and to analyse the results of uncemented total hip arthroplasty (THA) in patients with osteoarthritis and congenital dislocation of the hip (CDH) prior to iliofemoral distraction.
Method:
Twenty hips were followed-up for 5.8 years (1-12 years). First the THA components were implanted after soft tissue release. In the interval, iliofemoral distraction with an external distraction apparatus was conducted. The second surgery consisted of an open reduction. An iliofemoral distraction of 0.8 mm/day was monitored. The treatment time was 86 days (50-210 days). In 61 days (32-94 days) the hip joints were distracted for 51 mm (41-75 mm).
Result:
The Harris Hip Score increased significantly by 47 points. The SF-36 health score showed a satisfying increase in all patients.
Conclusion:
In experienced hands this method is a relatively safe procedure for limb-length equalization in patients with severe CDH.
