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Total hip arthroplasty combined with double-chevron subtrochanteric osteotomy

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Subtrochanteric femoral shortening and corrective osteotomy are regarded as an integral part of total hip arthroplasty for a completely dislocated hip or severe deformity of the proximal femur. Alternative femoral osteotomy techniques—transverse, oblique, step-cut, and V-shaped, have been described.

Methods

In this series, we performed 22 cementless total hip arthroplasties combined with double-chevron subtrochanteric osteotomies between 1997 and 2002. There were 17 females and 2 males. Their average age at the time of the operation was 59 years (range 41–74 years). Thirteen hips were completely dislocated, 8 hips needed treatment after a proximal femoral osteotomy, and there was 1 case of hip ankylosis.

Results

The mean length of the operation was 128 min (range 80–215 min). Mean total blood loss was 1442 g (range 809–2007 g), which included both the intraoperative blood loss and postoperative blood loss. After an average of 7.6 years of follow-up, the Japanese Orthopaedic Association Hip Score improved from 48 to 79. Three types of complication were observed. There were 4 early dislocations, 3 proximal splits, and 1 nonunion at the osteotomy site.

Conclusions

Our study shows that acceptable results are obtained from double-chevron subtrochanteric osteotomy for subtrochanteric femoral shortening and corrective osteotomy. However, total hip arthroplasty combined with subtrochanteric osteotomy is a technically demanding treatment option.

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Acknowledgments

The authors thank Dr Yukihiko Tsutsumi, Dr Toshimitsu Koga, Dr Takako Ishii, Dr Masamori Shigematsu, Dr Takafumi Shimazaki, and Dr Hidefumi Honke for their contributions to this study.

Conflict of interest

The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan

    Motoki Sonohata, Tomonori Tajima, Masaru Kitajima, Kenji Ogawa, Syunsuke Kawano, Masaaki Mawatari & Takao Hotokebuchi

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  1. Motoki Sonohata
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  2. Tomonori Tajima
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  3. Masaru Kitajima
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  4. Kenji Ogawa
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  5. Syunsuke Kawano
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  6. Masaaki Mawatari
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  7. Takao Hotokebuchi
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Corresponding author

Correspondence to Motoki Sonohata.

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Sonohata, M., Tajima, T., Kitajima, M. et al. Total hip arthroplasty combined with double-chevron subtrochanteric osteotomy. J Orthop Sci 17, 382–389 (2012). https://doi.org/10.1007/s00776-012-0240-x

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  • DOI: https://doi.org/10.1007/s00776-012-0240-x

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