[Cementless total hip replacement in patients with high total dislocation: the results of femoral shortening by subtrochanteric segmental resection]

A Yalçin Tabak, Levent Celebi, Hasan H Muratli, M Firat Yağmurlu, Cem N Aktekin, Ali Biçimoğlu
Acta Orthopaedica et Traumatologica Turcica 2003, 37 (4): 277-83

OBJECTIVES: We evaluated the results of femoral shortening by subtrochanteric segmental resection in patients who underwent total hip replacement (THR) for high total dislocation of the hip.

METHODS: We performed THR in 19 hips of 16 patients (15 females, 1 male; mean age 41 years; range 22 to 55 years) with high total dislocation of the hip. All the patients had severe hip pain. In all cases, femoral shortening by subtrochanteric segmental resection and an anatomical reconstruction of the acetabulum were performed with the use of cementless femoral components and cementless acetabular components with screws, respectively. The Harris hip scoring system was used for functional assessments. Radiologic assessments were based on the DeLee and Charnley criteria for the acetabular component, and on the Gruen zones and the Engh criteria for the femoral component. The mean follow-up period was 44 months (range 22 to 79 months).

RESULTS: Union was achieved in all cases in a mean of 14 weeks (range 11 to 15 weeks). The mean leg length discrepancy decreased from 4 cm to 1.5 cm postoperatively. A positive Trendelenburg sign was found in 13 patients and four patients before and after surgery, respectively. The mean Harris hip score improved from 37 to 83 postoperatively. None of the patients developed deep infection, dislocation, sciatic nerve palsy, or nonunion at the osteotomy site. No clinical and radiologic signs of loosening were observed and no revisions were required.

CONCLUSION: Femoral shortening with subtrochanteric segmental resection in THR is a safe technique in patients with high total dislocation of the hip, leading to satisfactory functional results.

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