Total hip arthroplasty with a monoblock conical stem and subtrochanteric transverse shortening osteotomy in Crowe...

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Hip Dysplasia Management

Background:

• Crowe type IV hip dysplasia presents complex challenges for total hip arthroplasty.
• Effective surgical management is crucial for improving patient function and long-term outcomes.

Purpose of the Study:

• To assess the clinical and radiographic outcomes of total hip arthroplasty (THA) with femoral shortening osteotomy in patients with Crowe type IV hip dysplasia.
• To evaluate the long-term survival and functional improvement following this surgical technique.

Main Methods:

• A series of patients with Crowe type IV hip dysplasia undergoing primary THA with subtrochanteric transverse osteotomy and an uncemented monoblock conical stem were included.
• Clinical and radiographic evaluations, including the Harris Hip Score (HHS), were performed pre-operatively, post-operatively, and at long-term follow-up.

Main Results:

• The study included 74 patients (102 hips) with a mean follow-up of 11.3 years.
• A high survivorship of 95.9% at ten years was observed, with only 1.9% requiring stem revision.
• The average Harris Hip Score significantly improved from 44 pre-operatively to 90.3 at final follow-up (p < 0.001).
• Osteotomy site non-union (3.9%) and early dislocation (3.8%) were reported, with no cases of nerve palsy.

Conclusions:

• Total hip arthroplasty combined with subtrochanteric transverse osteotomy and a monoblock conical stem demonstrates good long-term survival.
• This approach yields favorable clinical and radiographic results, making it an effective management option for Crowe type IV hip dysplasia.