Abstract
Introduction
The anatomic abnormalities associated with the dysplastic hip increase the complexity of hip arthroplasty, in addition previous femural osteotomy can deformate proximal femur. Despite the fact that uncemented cup and stems are specifically designed for dysplasia to recover the true acetabular region in Crowe IV and sometimes Crowe III additional surgical procedure are required. Purpose of the study is to verify surgical procedures and explore reconstruction options on severe hip dysplasia.
Materials and methods
In last 25 years, 2308 arthroplasties were performed in dysplastic hips (565 cases had a previous femoral osteotomy). In 128 cases was required a correction of femoral side deformity: in 64 cases was performed a greater trochanter osteotomy (in 12 of these a proximal femoral shortening was associated), 55 cases were treated by a shortening subtrochanteric osteotomy (that allows corrections in any plane) and in 9 cases was performed a distal femur osteotomy.
Discussion
Long-term results in these patients are steadily inferior to those obtained in general population (70% survival rate at 15 years). On femoral side early failures reflect learning curve and are due to insufficient fixation of osteotomies. Despite this, the more promising outcomes are concerning shortening sub-trochanteric osteotomy with uncemented stem but only early and mid-term data are available.
