Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmen
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ORIGINAL ARTICLE • HIP - ARTHROPLASTY
Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S‑ROM stem for Crowe type IV developmental dysplasia Libor Necas1,2 · Maros Hrubina1,2 · Marian Melisik1,2 · Zoltan Cibula1,2 · Michal Chmurny1,2 · Matej Daniel3 · Boris Steno4 Received: 3 November 2018 / Accepted: 11 February 2019 © Springer-Verlag France SAS, part of Springer Nature 2019
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
Introduction
* Maros Hrubina [email protected] 1
Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
2
University Department of Orthopaedic Surgery, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
3
Department of Mechanics, Biomechanics and Mechatronics, Faculty of Mechanical Engineering, Czech Technical University in Prague, Technicka 4, 166 07 Prague 6, Czech Republic
4
II. University Department of Orthopaedic and Trauma Surgery, University Hospital Bratislava, Antolska 11, 851 07 Bratislava, Slovak Republic
Total hip arthroplasty (THA) in patients with Crowe type IV developmental dysplasia of the hip (DDH) is a technically more demanding procedure and has a higher complication rate than surgery in primary coxarthrosis [1]. Anatomical abnormalities typically associated with high hip di
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