Abstract
Patients with dislocation, severe subluxation of the hip joints were treated with cementless THA combined with subtrochanteric shortening femoral osteotomy. Total hip arthroplasty (THA) requiring subtrochanteric osteot-omy has been considered to lead to several complications. The aim of this paper is to assess the clinical results and complications of this procedure.
An acetabular component was placed into position at the site of the true acetabulum. After femoral corrective shortening osteotomy for dislocation or severe sub-luxation of the hip joints, an AML cementless stem was tightly inserted into the femoral canal to achieve bony union and osteointegration with the implant.
Twenty-one patients (23 hips; 2 men, 19 women) treated with cementless THA combined with subtro-chanteric femoral shortening osteotomy were enrolled in this study. The mean age was 55 years and the mean follow-up period was 4.5 years.
The average elongation of the limb was 48 mm after subtrochanteric shortening femoral osteotomy. Solid union of the osteotomy was obtained within an average of 5.5 months after surgery. None of these patients developed sciatic nerve palsy. There were 4 cases of non-union of the osteotomy site and 3 of aseptic loosening of the femoral component related to intraoperative femoral fracture. Upward migration of the proximal part of the femur was related to poor preoperative bone quality.
In order to diminish these complications, careful patient selection, accurate femoral reaming and suitable methods of bone cutting and augmentation of the oste-otomy site are necessary.
The abstracts were prepared by Nico Verdonschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
