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Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmental dysplasia

  • Libor Necas
  • Maros HrubinaEmail author
  • Marian Melisik
  • Zoltan Cibula
  • Michal Chmurny
  • Matej Daniel
  • Boris Steno
Original Article • HIP - ARTHROPLASTY

Abstract

Introduction

The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem.

Methods

We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22–68) years. The operations were performed between 2007 and 2013. Patients were assessed retrospectively–clinically and radiographically during the year 2018.

Results

The mean follow-up period was 94 (range 60–134) months. The average Harris hip score improved from 39.9 to 84.0. The mean leg length discrepancy decreased from 5 cm preoperatively to 1.4 cm at the final follow-up. All acetabular components were implanted into the true acetabulum, and all prostheses were stable at the latest examination. No neurovascular damage was recorded. We have identified specific complications in seven hips (25%) in total: Intraoperative femoral fracture required fixation in four hips; three hips (10.7%) needed revision: Recurrent dislocation, with the need for cup reorientation, occurred in two hips (in one of them, this was followed by the subsequent need for resection of heterotopic ossification); there was one aseptic stem loosening with the need of one-stage revision. All the osteotomies healed within 8 months.

Conclusion

Hip arthroplasty with transverse shortening femoral osteotomy, using S-ROM stem, is an acceptable, but not complication-free treatment method in patients with Crowe type IV developmental hip dysplasia, in the midterm.

Keywords

Hip dysplasia Shortening femoral osteotomy S-ROM stem 

Notes

Acknowledgements

This research is supported by AZV MZ CR Project No. 15-31269A.

Compliance with ethical standards

Conflict of interest

The authors state that there are no conflicts of interest regarding the publication of this article.

Human and animal rights

Every institution involved in this work has approved the human protocol for this investigation.

Informed consent

Informed consent was obtained from the participants, and all investigations were conducted in conformity with ethical principles.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Jessenius Faculty of Medicine in MartinComenius University in BratislavaMartinSlovak Republic
  2. 2.University Department of Orthopaedic SurgeryUniversity Hospital MartinMartinSlovak Republic
  3. 3.Department of Mechanics, Biomechanics and Mechatronics, Faculty of Mechanical EngineeringCzech Technical University in PraguePrague 6Czech Republic
  4. 4.II. University Department of Orthopaedic and Trauma SurgeryUniversity Hospital BratislavaBratislavaSlovak Republic

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