Medium-term Evaluation Of Cementless Modular Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy For Hips With Developmental Dysplasia

Objective: The purpose of this retrospective study was to analyze themedium-term functional and radiographic results of cementless, modular total hiparthroplasty combined with subtrochanteric osteotomy for the treatment of patients whohad had Crowe Group-IV developmental dysplasia of the hip.Methods: From January2004to December2012,twenty-four consecutive patients(twenty-six hips) who had previously had Crowe Group-IV developmental dysplasia ofthe hip were treated with a modular cementless prosthesis（S-ROM，Depuy）. Thepreoperative and postoperative Harris score were compared.After operation,wemeasured the greater trochanter and the hip center downward mobility distance,limbextension distance and the biological fixation effect of the prosthesis were followed-upwith radiographic results.Results:20patients(20hips)were followed up between13to96monthes，average（39.3±22.9）monthes.The Harris score was improved significantly(P<0.05).The greatertrochanter shifted distally to an average of（49.1±9.5）mm,and the hip center to anaverage of （48.0±9.2）mm postoperatively. The limb extended to an average of（4.9±3.4）mm. Two patients had a slight limp at the time of1year after surgery,othershad no limp and hip pain. Postoperative dislocations occured in two hips.Two patientsoccured deep vein thrombosis,and one patient fracture.Other cases encountered nocomplications with fracture,infection,dislocation,symptomatic deep veinthrombosis,vascular injury and nerve plasy.No loosening and subsidence occured.NOcase was revised.Conclusions: Cementless, modular total hip arthroplasty combined withsubtrochanteric osteotomy for the treatment of patients with prior Crowe Group-IVdevelopmental dysplasia of the hip resulted in satisfactory outcomes.