Related Experiment Video
Updated: May 16, 2026
Surgical Technique of the 3-Dimensional-printed Personalized Hip Implant for the Treatment of Canine Hip Dysplasia
Published on: April 19, 2024
Long-term results of intertrochanteric varus osteotomy for the dysplastic hip
Takayuki Nishiyama1, Yasuhiro Saegusa, Takaaki Fujishiro
1Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. nishiyam@med.kobe-u.ac.jp
Insights
Combined hip surgery, including intertrochanteric varus osteotomy and acetabuloplasty, offers better outcomes for young patients with early-stage hip dysplasia compared to osteotomy alone.
Area of Science:
- Orthopedic Surgery
- Hip Preservation
- Biomechanical Engineering
Background:
- Total hip arthroplasty (THA) poses challenges in young patients due to potential complications like loosening and infection.
- Acetabular dysplasia often requires surgical intervention to improve hip joint stability and coverage.
- Traditional intertrochanteric varus osteotomy inadequately addresses femoral head coverage in dysplastic hips.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of combined intertrochanteric varus osteotomy and acetabuloplasty for hip dysplasia.
- To compare the efficacy of this combined procedure against intertrochanteric varus osteotomy alone in treating early-stage hip arthrosis secondary to dysplasia.
- To identify factors influencing functional outcomes after surgical hip reconstruction.
Main Methods:
- A retrospective review of 104 hips in 84 patients with acetabular dysplasia treated between 1969 and 1994.
- Patients underwent either intertrochanteric varus osteotomy alone (38 hips) or combined with acetabuloplasty (63 hips).
- Clinical assessment using Harris hip score and radiographic evaluation including centre-edge angle were performed over a 15-year follow-up.
Main Results:
- The combined group demonstrated significantly higher average Harris hip scores at the latest follow-up compared to the varus-only group.
- Postoperative centre-edge angle and patient age at operation were correlated with long-term functional outcomes (Harris hip score).
- The combined procedure showed improved outcomes in patients with early-stage hip dysplasia.
Conclusions:
- Combined intertrochanteric varus osteotomy and acetabuloplasty is a viable treatment option for young patients with early-stage hip dysplasia.
- This combined approach offers superior functional results compared to osteotomy alone.
- The procedure should be considered for hip preservation in carefully selected young patients with acetabular dysplasia.
Abstract:
Total hip arthroplasty (THA) is a well established treatment for arthrosis of the hip, however many problems remain which have not yet been resolved, including component loosening and infection. Therefore, surgeons hesitate to perform THA in younger patients showing early signs of the disease. Intertrochanteric varus osteotomy was developed for osteoarthrosis with coxa valga. This procedure has been commonly used in patients with dysplastic hips. However, femoral head coverage is not sufficiently improved by this procedure. In order to overcome the disadvantages of this procedure, since 1972 we performed intertrochanteric varus osteotomy simultaneously combined with acetabuloplasty for the treatment of osteoarthrosis secondary to dysplasia. Between 1969 and 1994, we performed 104 intertrochanteric varus osteotomies for prearthrosis and early stage arthrosis of the hip due to acetabular dysplasia in 84 patients. In this study, we reviewed these patients clinically and radiographically, over 15 years. The intertrochanteric varus osteotomy alone was employed in 38 hips (varus group). Combined intertrochanteric varus osteotomy and acetabuloplasty was employed in 63 hips (combined group). The average Harris hip score at the latest follow-up in the combined group significantly higher than that in the 'varus' group. Postoperative centre-edge angle and age at operation were correlated with the Harris hip score at the most recent follow-up. The results of the present study indicate that this combined intertrochanteric varus osteotomy and acetabuloplasty for dysplastic hip should be considered in young patients when the disease is at an early stage.
