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[Hip joint arthrodesis using the cobra plate. Indication, technique, outcome]
Insights
Hip arthrodesis using the cobra plate is a viable option for severe hip joint deterioration, offering pain relief for many. While technically demanding, it facilitates early mobilization and has a low risk of non-union.
Area of Science:
- Orthopedic Surgery
- Surgical Techniques
- Hip Joint Reconstruction
Background:
- Hip arthrodesis is infrequently performed due to advancements in total hip replacement.
- Indications include severe hip joint deterioration, pain, limited motion, and contraindications to joint replacement, particularly in young patients.
- Specific conditions like sepsis, slipped capital epiphysis, Perthes' disease, trauma, paralysis, or muscle loss necessitate hip fusion.
Purpose of the Study:
- To evaluate the efficacy and outcomes of hip arthrodesis using the cobra plate.
- To assess complication rates, union rates, and functional results in patients undergoing this procedure.
Main Methods:
- A retrospective review of 20 consecutive patients who underwent hip arthrodesis with a cobra plate between 1980 and 1990.
- Radiographic and clinical follow-up was conducted for all patients.
Main Results:
- A 20% complication rate (5 out of 25 cases) was observed, including two cases of infection and two requiring re-osteosynthesis with bone grafting.
- All patients achieved radiographic union, with 13 reporting pain-free ambulation.
- Five patients expressed dissatisfaction due to the functional limitations of a fused hip.
Conclusions:
- Hip arthrodesis with the cobra plate is a technically challenging procedure but allows for early mobilization and partial weight-bearing.
- The risk of non-union is low compared to other surgical methods.
- Proper surgical technique is crucial for minimizing functional problems and achieving satisfactory outcomes.
Abstract:
In the era of successful total hip replacement, hip arthrodesis has become an infrequent surgical procedure. Current indications are severe deterioration of the hip joint with a painful, reduced range of motion in young patients, such as disorders subsequent to sepsis of the hip joint, slipped capital epiphysis, Perthes' disease and trauma with contraindications for a total joint replacement. Another important indication is paralysis or musculature loss. From 1980 to 1990, 20 consecutive patients underwent a hip arthrodesis with a cobra plate and were evaluated. None of the patients was lost for follow-up; complications occurred in 5 out of 25 cases (20%). All patients had radiographic evidence of union, 2 patients required re-osteosynthesis and bone grafting. In two cases infection occurred. In one case the position of the fused join went into abduction. Thirteen patients were able to walk free of pain; however, 5 patients were disappointed with the arthrodesis result because of the handicap involved with a fused hip. Hip arthrodesis using the cobra plate is a technically demanding operation, but immediate mobilization and partial weight bearing are facilitated. There is little risk of non-union compared to other surgical procedures. If the technique is correct functional problems will be rare.
