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Total Hip Arthroplasty for High Hip Dislocation.

Sebastian Hardt¹, Robert Hube², Carsten Perka¹

¹Musculoskeletal Surgery Centre, Charité - University Medicine Berlin.

Zeitschrift Fur Orthopadie Und Unfallchirurgie

|March 5, 2020

Summary

This summary is machine-generated.

Total hip arthroplasty for high hip dislocation is complex. Subtrochanteric shortening osteotomy with anatomic reconstruction yields good results, with only slightly increased long-term loosening rates.

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Area of Science:

Orthopedic Surgery
Biomedical Engineering

Background:

Total hip arthroplasty (THA) in high hip dislocation is challenging due to congenital hip abnormalities.
Anatomical variations necessitate specialized surgical approaches for successful implantation.

Purpose of the Study:

To evaluate the efficacy of subtrochanteric shortening osteotomy in conjunction with THA for high hip dislocation.
To achieve anatomical reconstruction of the hip's center of rotation.

Main Methods:

The procedure involves anterolateral or posterolateral approaches, prioritizing preservation of pelvitrochanteric muscles.
Planned subtrochanteric shortening osteotomy is performed, with bone fragment size determined by preoperative measurements.
Acetabular component placement focuses on restoring the original center of rotation.

Main Results:

Good functional outcomes were observed following subtrochanteric shortening osteotomy and THA.
A slight increase in 10-year implant loosening rates was noted compared to standard primary hip osteoarthritis management.
Common complications include nerve injuries, fractures, component malpositioning, and instability.

Conclusions:

Subtrochanteric shortening osteotomy is an effective technique for managing high hip dislocation during THA.
This approach achieves favorable functional results with acceptable long-term implant survival rates.