Total Hip Arthroplasty With Wagner Cone Stem And Transverse Subtrochanteric Osteotomy In Treatment Of Crowe Type ? Developmental Dysplasia Of The Hip

Objective:To analyze the clinical outcome and complications of total hip arthroplasty(THA)with Wagner Cone stem and transverse subtrochanteric osteotomy in treatment of Crowe type IV Developmental Dysplasia of the Hip(DDH).Method:51 patients(67 hips)with a mean age of 35.8 years at time of index operation who underwent THA with Wagner Cone stem and transverse subtrochanteric osteotomy from January,2009 to December,2015 were included in our study.There were 44 women and 7 men,all of whom had Crowe type IV DDH.The average duration of follow-up was 54 months(Range 24-108 months).The clinical function of the patients was evaluated by Harris Hip score and AP pelvic view and full-length view of the lower extremities were used to evaluate the position of prosthesis,the healing of osteotomy,the osteolysis and the sinking of prosthesis.Result: Average follow-up time of 54 months(24-108 months),the mean Harris hip score was improved from 37.5(range:30-55)preoperatively to 85.8 postoperatively(range:78-96),and there were statistically significant differences in Harris hip score(p<0.05).Mean leg-length discrepancy had decreased from 3.8cm(range,0-8 cm)preoperatively to 0.8 cm(range,0-1.5cm)by the latest follow-up evaluation.Femoral shortening subtrochanteric osteotomy was performed with an average femoral resection of 3.1cm(range:1.5-6.5cm).There were 3 cases of intraoperative fracture,5 cases of postoperative dislocation,1 case of nonunion(2 hips),without infection,nerve palsy,prosthesis loosening and sinking.Conclusion:Our data demonstrated that the total hip arthroplasty with Wagner Cone stem and transverse subtrochanteric osteotomy for Crowe IV developmental dysplasia of the hip could obtain satisfactory clinical outcomes with less complications and effectively balance the length of two lower limbs and simplify the complexity of the operation.