Abstract
Objectives
There are few reports on total hip arthroplasty (THA) for hip osteoarthritis associated with so-called Perthes-like change including high great trochanter, short neck hip or flattened femoral head (hereinafter called “Perthes-like change”) as the operative procedures are difficult. We studied THA for “Perthes-like change” carried out in our department.
Methods
We covered 14 cases (15 hips), which underwent THA for “Perthes-like change” (hereinafter called “Perthes-like change group,” operated from 2008 to September 2011. The average age at the operation was 62 (53 to 83 years old), 7 males and 7 females, and the average follow-up period was 21.8 months (6 to 48 months). For these cases we studied the clinical items and further made a comparative review of the 258 hips as a control group (Group C), which underwent THA during the same period for osteoarthritis (OA) originating in DDH (developmental dysplasia of the hip) (Crowe type 1 and 2), excluding the “Perthes-like change group.” The items reviewed include the age at the operation, operation time and intraoperative blood loss.
Results
The average JOA score of the “Perthes-like change group” at the time of the study was 89 and favorable. The average operation time of the “Perthes-like change group” was 113 minutes (69 to 202 minutes) and its average intraoperative blood loss was 1066 g (490 to 3314 g). The operation time of the “Perthes-like change group” was significantly longer compared to that of the Group C (p=0.004), and its intraoperative blood loss was also significantly larger than that of the Group C (p=0.018). We carried out the muscle release operation for 8 hips (53.3%) of the “Perthes-like change group” and we combined the retachment of the great trochanter for the 1 case of them. There was no dislocation, infection, neuroparalysis and pulmonary embolism.
Consideration
The “Perthes-like change group” had a longer operation time and a larger intraoperative blood loss than those of the Group C. Also there were quite a few cases that needed muscle release operation. Therefore, care should be taken in THA for hip osteoarthritis associated with “Perthes-like change” although the clinical results were favorable.
