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Level of osteotomy is relevant to obtain better union and clinical results in patients with severe hip dysplasia operated on with total hip arthroplasty and shortening osteotomy using a cementless, rectangular femoral component

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction and objective

Total hip arthroplasty with rectangular femoral component and transverse osteotomy for patients with Crowe type 3 or 4 dysplasia yields successful results with varying radiological findings. This study aims to investigate the surgery and patient related factors associated with successful clinical and radiological results.

Patients and methods

Fifty hips of 41 patients were retrospectively examined. Length and percentage of the stem passing the osteotomy level and canal fill ratio were measured. Radiological findings such as radiolucent lines (RL) around the stem, hypertrophic callus or an identifiable osteotomy line on X-ray images were assessed. All clinical and radiological results were analyzed for any significant association.

Results

Mean stem length and percentage passing the osteotomy level were 6.4 cm (± 0.7) and 51% (± 6). Presence of an identifiable osteotomy line was positively associated with the increasing length of the stem passing the osteotomy level and with a lower HHS (p < 0.05). RL around the stem were associated with a lesser reduction in VAS score (p < 0.05).

Conclusion

Rectangular femoral stem conveniently accommodate the proximal femur in severely dysplastic hips. An upper limit for the femoral stem exists to obtain better bony union and higher HHS. RL around the stem are clinically relevant and is associated with a worse VAS score at the latest follow-up.

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Acknowledgements

The authors would like to thank Dr. Enes Ahmet Guven for his valuable contribution regarding the statistical analysis.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Istanbul Taksim Training and Research Hospital, Istanbul, Turkey

    Mahmut Enes Kayaalp

  2. Nisantasi Orthopaedics Center, Istanbul, Turkey

    Ata Can & Fahri Erdogan

  3. Department of Orthopaedics and Traumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa cd, 34098, Fatih, Istanbul, Turkey

    Mahmut Kursat Ozsahin, Onder Aydingoz & Gokhan Kaynak

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  1. Mahmut Enes Kayaalp
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Kayaalp, M.E., Can, A., Erdogan, F. et al. Level of osteotomy is relevant to obtain better union and clinical results in patients with severe hip dysplasia operated on with total hip arthroplasty and shortening osteotomy using a cementless, rectangular femoral component. Arch Orthop Trauma Surg 141, 155–163 (2021). https://doi.org/10.1007/s00402-020-03659-1

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