Abstract
Aim
The purpose of this study was to describe the rationale and to analyse the results of uncemented total hip arthroplasty (THA) in patients with osteoarthritis and congenital dislocation of the hip (CDH) prior to iliofemoral distraction.
Method
Twenty hips were followed-up for 5.8 years (1–12 years). First the THA components were implanted after soft tissue release. In the interval, iliofemoral distraction with an external distraction apparatus was conducted. The second surgery consisted of an open reduction. An iliofemoral distraction of 0.8 mm/day was monitored. The treatment time was 86 days (50–210 days). In 61 days (32–94 days) the hip joints were distracted for 51 mm (41–75 mm).
Result
The Harris Hip Score increased significantly by 47 points. The SF-36 health score showed a satisfying increase in all patients.
Conclusion
In experienced hands this method is a relatively safe procedure for limb-length equalization in patients with severe CDH.
Similar content being viewed by others
References
Charnley J, Feagin JA (1973) Low-friction arthroplasty in congenital subluxation of the hip. Clin Orthop Relat Res 91:98–113
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
DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32
Eggli S, Hankemayer S, Muller ME (1999) Nerve palsy after leg lengthening in total replacement arthroplasty for developmental dysplasia of the hip. J Bone Joint Surg Br 81:843–845
Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27
Harris WH, Crothers O, Oh I (1977) Total hip replacement and femoral-head bone-grafting for severe acetabular deficiency in adults. J Bone Joint Surg Am 59:752–759
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 et al (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
Huo MH, Salvati EA, Lieberman JR et al (1993) Custom-designed femoral prostheses in total hip arthroplasty done with cement for severe dysplasia of the hip. J Bone Joint Surg Am 75:1497–1504
Johanson NA, Pellicci PM, Tsairis P et al (1983) Nerve injury in total hip arthroplasty. Clin Orthop Relat Res 179:214–222
Kerboull M, Hamadouche M, Kerboull L (2001) Total hip arthroplasty for Crowe type IV developmental hip dysplasia: a long-term follow-up study. J Arthroplasty 16:170–176
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
Lai KA, Shen WJ, Huang LW et al (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
Lerch M, Windhagen H, von Lewinski G et al (2007) Intraoperative femoral fractures during the implantation of the cementless BiCONTACT stem: a matched-pair analysis of 84 patients. Z Orthop Unfall 145:574–578
Masonis JL, Patel JV, Miu A et al (2003) Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. J Arthroplasty 18:68–73
Paavilainen T, Hoikka V, Paavolainen P (1993) Cementless total hip arthroplasty for congenitally dislocated or dysplastic hips. Technique for replacement with a straight femoral component. Clin Orthop Relat Res 297:71–81
Russotti GM, Harris WH (1991) Proximal placement of the acetabular component in total hip arthroplasty. A long-term follow-up study. J Bone Joint Surg Am 73:587–592
Schutzer SF, Harris WH (1994) High placement of porous-coated acetabular components in complex total hip arthroplasty. J Arthroplasty 9:359–367
Sugano N, Noble PC, Kamaric E et al (1998) The morphology of the femur in developmental dysplasia of the hip. J Bone Joint Surg Br 80:711–719
Young NL, Davis RJ, Bell DF et al (1993) Electromyographic and nerve conduction changes after tibial lengthening by the Ilizarov method. J Pediatr Orthop 13:473–477
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lerch, M., Thorey, F., von Lewinski, G. et al. An alternative treatment method to restore limb-length discrepancy in osteoarthritis with high congenital hip dislocation. Arch Orthop Trauma Surg 129, 1593–1599 (2009). https://doi.org/10.1007/s00402-009-0846-4
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-009-0846-4