Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmental dysplasia
- 187 Downloads
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.
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.
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.
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.
KeywordsHip dysplasia Shortening femoral osteotomy S-ROM stem
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 was obtained from the participants, and all investigations were conducted in conformity with ethical principles.
- 2.Argenson JN, Flecher X, Parratte S, Aubaniac JM (2007) Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res 465(12):40–45Google Scholar
- 5.Desteli EE, Imren Y, Tan E et al (2015) Clinical results of cementless total hip arthroplasty with shortening osteotomy for high dislocation with developmental dysplasia. Acta Orthop Belg 81(1):30–35Google Scholar
- 18.Mattingly DA (2005) The S-ROM modular femoral stem in dysplasia of the hip. Orthopedics 28(9 suppl):1069–1073Google Scholar
- 23.Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141(6):17–27Google Scholar
- 24.DeLee J, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121(11):20–32Google Scholar
- 25.Cohen J (1988) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Elbaum, HillsdaleGoogle Scholar