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Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmental dysplasia

  • Original Article • HIP - ARTHROPLASTY
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Abstract

Introduction

The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem.

Methods

We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22–68) years. The operations were performed between 2007 and 2013. Patients were assessed retrospectively–clinically and radiographically during the year 2018.

Results

The mean follow-up period was 94 (range 60–134) months. The average Harris hip score improved from 39.9 to 84.0. The mean leg length discrepancy decreased from 5 cm preoperatively to 1.4 cm at the final follow-up. All acetabular components were implanted into the true acetabulum, and all prostheses were stable at the latest examination. No neurovascular damage was recorded. We have identified specific complications in seven hips (25%) in total: Intraoperative femoral fracture required fixation in four hips; three hips (10.7%) needed revision: Recurrent dislocation, with the need for cup reorientation, occurred in two hips (in one of them, this was followed by the subsequent need for resection of heterotopic ossification); there was one aseptic stem loosening with the need of one-stage revision. All the osteotomies healed within 8 months.

Conclusion

Hip arthroplasty with transverse shortening femoral osteotomy, using S-ROM stem, is an acceptable, but not complication-free treatment method in patients with Crowe type IV developmental hip dysplasia, in the midterm.

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Acknowledgements

This research is supported by AZV MZ CR Project No. 15-31269A.

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Authors and Affiliations

  1. Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic

    Libor Necas, Maros Hrubina, Marian Melisik, Zoltan Cibula & Michal Chmurny

  2. University Department of Orthopaedic Surgery, University Hospital Martin, Kollarova 2, 036 59, Martin, Slovak Republic

    Libor Necas, Maros Hrubina, Marian Melisik, Zoltan Cibula & Michal Chmurny

  3. Department of Mechanics, Biomechanics and Mechatronics, Faculty of Mechanical Engineering, Czech Technical University in Prague, Technicka 4, 166 07, Prague 6, Czech Republic

    Matej Daniel

  4. II. University Department of Orthopaedic and Trauma Surgery, University Hospital Bratislava, Antolska 11, 851 07, Bratislava, Slovak Republic

    Boris Steno

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  1. Libor Necas
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  2. Maros Hrubina
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Correspondence to Maros Hrubina.

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Necas, L., Hrubina, M., Melisik, M. et al. Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmental dysplasia. Eur J Orthop Surg Traumatol 29, 1025–1033 (2019). https://doi.org/10.1007/s00590-019-02400-y

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