Total hip arthroplasty with femoral osteotomy and modular prosthesis for proximal femoral deformity
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(2019) 14:282
RESEARCH ARTICLE
Open Access
Total hip arthroplasty with femoral osteotomy and modular prosthesis for proximal femoral deformity Xiaowen Deng1†, Jun Liu1†, Tao Qu1, Xusheng Li1, Ping Zhen1, Qiuming Gao1, Yun Xue1, Peng Liu1, Guoding Cao1 and Xiaole He2*
Abstract Background: Severe anatomical abnormalities exist in proximal femoral deformities (PFDs). Total hip arthroplasty (THA) is associated with drawbacks such as high surgical complexity, long operation time, requirement for high surgical skills, high incidences of postoperative complications, and poor efficacy. Objective: This study aimed to investigate the short-term efficacy of THA with femoral osteotomy and modular prosthesis implantation for femoral fixation and reconstruction in patients with PFD. Methods: A total of 15 patients (15 hips) with rotational PFD treated with THA with femoral osteotomy and modular prosthesis between August 2012 and September 2014 were included. There were 10 male (10 hips) and 5 female (5 hips) patients. Preoperative limb shortening, intraoperative osteotomy length, and postoperative limb length were recorded. The Harris hip score was adopted for assessing the clinical results. Postoperative radiography was performed to observe the prosthesis position, as well as the presence or absence of abnormalities such as osteolysis, loosening, and subsidence of the prosthesis. Results: All 15 patients were followed up postoperatively, with a mean follow-up duration of 62.5 (range 20–85) months. The postoperative limb-length discrepancy (1.0 ± 0.5 cm) was significantly less than the preoperative discrepancy (3.2 ± 1.2 cm) (t = − 2.501, P = 0.002). The Harris hip score significantly improved from a mean of 47.2 ± 9.9 points preoperatively to 89.7 ± 3.9 points during the last follow-up visit (t = 21.31, P = 0.001). Immediate postoperative radiographs showed restoration of limb alignment after femoral osteotomy, excellent initial press-fit fixation of the S-ROM prosthesis, and good canal filling. According to Engh’s criteria, all 15 hips were graded as ingrown bones. No infection, prosthesis loosening, periprosthetic fracture, or other complications occurred. Conclusion: In patients with femoral deformities treated with THA, precise osteotomy, good coaptation of the osteotomy surfaces, and correct choice of modular S-ROM prostheses for femoral reconstruction and fixation remain the key factors for surgical success. Keywords: Proximal femoral deformity, Femoral osteotomy, Total hip arthroplasty, Modular S-ROM prosthesis, Femoral reconstruction
* Correspondence: [email protected] † Xiaowen Deng and Jun Liu contributed equally to this work. 2 Department of Geriatrics Center, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, China Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestri
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