Abstract
The aim of this study was to prospectively evaluate our single-centre one- and five-year results of anatomically correct cementless total hip arthroplasty in unilateral and bilateral Crowe type IV high hip dislocations in ten hips following iliofemoral monotube soft tissue distraction. Six consecutive patients (five females and one male) with unilateral and two female patients with bilateral high hip dislocation with an average age of 46 years and height of dislocation up to 110 mm were treated in our institution. Limb lengthening was achieved up to 100 mm. The mean leg-length-discrepancy was −4 mm postoperatively. Harris hip score increased significantly at one year (p < 0.001) and significantly further (p < 0.05) at five years postoperative. WOMAC, VAS pain scale as well as gait and pain-free walking distance also improved significantly at follow-up. Two pin infections and one temporary peroneal nerve palsy occurred during monotube extension. Three cup protrusions that required revision surgery were observed in two patients. This study shows that iliofemoral distraction prior to total hip replacement achieves leg length equality and improved gluteal function and therefore gait in patients with Crowe type IV hip dislocation.
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Hartofilakidis G, Stamos K, Ioannidis TT (1988) Low friction arthroplasty for old untreated congenital dislocation of the hip. J Bone Joint Surg Br 70:182–186
Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23
Delimar D, Cicak N, Klobucar H, Pecina M, Korzinek K (2002) Acetabular roof reconstruction with pedicled iliac graft. Int Orthop 26:344–348. doi:10.1007/s00264-002-0381-1
Pitto RP, Schikora N (2004) Acetabular reconstruction in developmental hip dysplasia using reinforcement ring with a hook. Int Orthop 28:202–205. doi:10.1007/s00264-004-0559-9
Papachristou G, Hatzigrigoris P, Panousis K, Plessas S, Sourlas J, Levidiotis C, Chronopoulos E (2006) Total hip arthroplasty for developmental hip dysplasia. Int Orthop 30:21–25. doi:10.1007/s00264-005-0027-1
Charnley J, Feagin JA (1973) Low-friction arthroplasty in congenital subluxation of the hip. Clin Orthop Relat Res:98–113
Dunn HK, Hess WE (1976) Total hip reconstruction in chronically dislocated hips. J Bone Joint Surg Am 58:838–845
Hartofilakidis G, Georgiades G, Babis GC, Yiannakopoulos CK (2008) Evaluation of two surgical techniques for acetabular reconstruction in total hip replacement for congenital hip disease: results after a minimum ten-year follow-up. J Bone Joint Surg Br 90:724–730. doi:10.1302/0301-620X.90B6.20490
Hartofilakidis G, Karachalios T (2004) Total hip arthroplasty for congenital hip disease. J Bone Joint Surg Am 86-A:242–250
Hartofilakidis G, Stamos K, Karachalios T (1998) Treatment of high dislocation of the hip in adults with total hip arthroplasty. Operative technique and long-term clinical results. J Bone Joint Surg Am 80:510–517
Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N (1996) Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 78:683–692
Numair J, Joshi AB, Murphy JC, Porter ML, Hardinge K (1997) Total hip arthroplasty for congenital dysplasia or dislocation of the hip. Survivorship analysis and long-term results. J Bone Joint Surg Am 79:1352–1360
Paavilainen T, Hoikka V, Solonen KA (1990) Cementless total replacement for severely dysplastic or dislocated hips. J Bone Joint Surg Br 72:205–211
Lai KA, Shen WJ, Huang LW, Chen MY (2005) Cementless total hip arthroplasty and limb-length equalization in patients with unilateral Crowe type-IV hip dislocation. J Bone Joint Surg Am 87:339–345. doi:10.2106/JBJS.D.02097
Lai KA, Liu J, Liu TK (1996) Use of iliofemoral distraction in reducing high congenital dislocation of the hip before total hip arthroplasty. J Arthroplasty 11:588–593
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840
Stucki G, Meier D, Stucki S, Michel BA, Tyndall AG, Dick W, Theiler R (1996) Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) arthrosis index. Z Rheumatol 55:40–49
Bellamy N (1995) WOMAC osteoarthritis index: a user's guide. Victoria Hospital, London, Ontario, Canada
Grubl A, Chiari C, Giurea A, Gruber M, Kaider A, Marker M, Zehetgruber H, Gottsauner-Wolf F (2006) Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88:2210–2215. doi:10.2106/JBJS.E.00810
Grubl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F (2002) Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum ten-year follow-up. J Bone Joint Surg Am 84-A:425–431
Schatzker J, Glynn MK, Ritter D (1984) A preliminary review of the Muller acetabular and Burch-Schneider antiprotrusio support rings. Arch Orthop Trauma Surg 103:5–12
Sunderland S (1968) Nerves and nerve injury, 2nd edn. Churchill Livingstone, New York, pp 62–66
Argenson JN, Flecher X, Parratte S, Aubaniac JM (2007) Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res 465:40–45. doi:10.1097/BLO.0b013e3181576052
Iida H, Matsusue Y, Kawanabe K, Okumura H, Yamamuro T, Nakamura T (2000) Cemented total hip arthroplasty with acetabular bone graft for developmental dysplasia. Long-term results and survivorship analysis. J Bone Joint Surg Br 82:176–184
Bicanic G, Delimar D, Delimar M, Pecina M (2009) Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop 33:397–402. doi:10.1007/s00264-008-0683-z
Graf R (1980) The diagnosis of congenital hip-joint dislocation by the ultrasonic Combound treatment. Arch Orthop Trauma Surg 97:117–133
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Holinka, J., Pfeiffer, M., Hofstaetter, J.G. et al. Total hip replacement in congenital high hip dislocation following iliofemoral monotube distraction. International Orthopaedics (SICOT) 35, 639–645 (2011). https://doi.org/10.1007/s00264-010-1001-0
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DOI: https://doi.org/10.1007/s00264-010-1001-0