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Updated: Jun 14, 2025
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
[Total hip arthroplasty with supracondylar shortening osteotomy in Crowe 4 inveterate hip dislocation: case report
E Macías-González1, N Restrepo-Giraldo2
1Traumatología y Ortopedia. Hospital General Xoco. Ciudad de México, México.
Insights
Developmental dysplasia of the hip (DDH) often requires total hip arthroplasty (THA). This study presents a novel surgical technique combining acetabular reconstruction with femoral osteotomy to restore hip biomechanics and preserve bone.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
Background:
- Developmental dysplasia of the hip (DDH) frequently leads to acetabular deformities necessitating total hip arthroplasty (THA).
- Current surgical approaches, including subtrochanteric osteotomy, show good long-term results but may not optimize hip biomechanics.
- A need exists for alternative techniques that restore the native center of rotation and preserve proximal bone.
Observation:
- This study details a surgical technique for a 29-year-old female patient with DDH and Crowe type 4 dislocation.
- The procedure involved a CorTical-sparing Acetabular (CTA) reconstruction combined with a supracondylar shortening osteotomy.
- Implants included an uncemented acetabular cup, a short uncemented stem with ceramic-polyethylene bearing, and distal fixation with a locking compression plate (LC-CP).
Findings:
- The primary goal was to restore the natural biomechanics of the hip joint.
- Potential benefits include improved center of rotation restoration and proximal bone preservation.
- The technique aims to reduce complications associated with traditional THA in complex DDH cases.
Implications:
- This surgical approach offers a potential therapeutic alternative for complex DDH cases requiring THA.
- It may lead to improved functional outcomes and reduced revision rates by preserving native hip anatomy.
- Further research and long-term follow-up are warranted to validate the efficacy and safety of this technique.
Abstract:
Structural deformities of the acetabulum secondary to developmental dysplasia of the hip (DDH) are one of the most common causes requiring total hip arthroplasty (THA), whether in conjunction with femoral osteotomy in cases of Crowe dislocation 4. Several techniques have been described, studied, and compared, but there is no superiority of one technique over another. Currently, most hip surgeons perform a subtrochanteric osteotomy. With a follow-up of 10 years, good results have been obtained, so there is a need to present a therapeutic alternative with potential benefits, mainly in restoring the center of rotation of the hip, preserving the proximal bone component, and reducing complications. Therefore, this study aims to describe the surgical technique of CTA in conjunction with supracondylar shortening osteotomy in a 29-year-old female patient, using an uncemented acetabular cup, a short uncemented stem with ceramic-polyethylene bearing, and distal fixation with a 4-hole plate LC-LCP, with the goal of restoring the natural biomechanics of the hip.
