Document Detail


Cemented total hip arthroplasty with subtrochanteric osteotomy in dysplastic hips.
MedLine Citation:
PMID:  20461484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Total hip arthroplasty (THA) in the presence of developmental dysplasia of the hip (DDH) can be technically challenging. Restoring the anatomic center of hip rotation may require femoral osteotomy. Techniques using cementless components are widely reported but less is known about using cemented components that may be more appropriate with osteopenic bone.
QUESTIONS/PURPOSES: We therefore determined the rate of union, complications, and early functional score in a series of patients with DDH who underwent cemented THA and simultaneous subtrochanteric osteotomy.
METHODS: We retrospectively reviewed 28 patients (35 hips) who underwent a cemented THA for DDH at a mean age of 47.3 years. Two patients (two hips) died within 12 months of surgery of unrelated conditions. The clinical notes and radiographs were reviewed with a minimum followup of 2 years (mean, 5.6 years; range, 2-14 years). Complications were noted. SF-12 and Oxford hip scores (OHS) were recorded for 18 patients preoperatively and after 6 and 12 months.
RESULTS: Union occurred in 32 of 33 femora (97%); one patient had an infected nonunion. The overall revision rate was 20% (9% femoral revision rate). There were three dislocations, two of which had further surgery. Two patients had a transient neuropraxia. The mean SF-12 physical component score increased from 32 to 52 and mean SF-12 mental component score increased from 48 to 51. The mean OHS decreased from 40 to 27.
CONCLUSION: Combined subtrochanteric osteotomy and cemented THA is technically demanding with a higher complication rate than routine THA. The rate of union, complications, implant survival, and early OHS were comparable to those for similar techniques using cementless components.
Authors:
Colin R Howie; Nicholas E Ohly; Ben Miller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-06     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3240-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK. colin.howie@luht.scot.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthroplasty, Replacement, Hip* / adverse effects,  mortality
Bone Cements / adverse effects,  therapeutic use*
Femur / radiography,  surgery*
Hip Dislocation, Congenital / mortality,  physiopathology,  radiography,  surgery*
Hip Joint / physiopathology,  radiography,  surgery*
Humans
Middle Aged
Osteotomy* / adverse effects,  mortality
Prosthesis Failure
Range of Motion, Articular
Reoperation
Retrospective Studies
Scotland
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bone Cements
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