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General Orthopaedics

TOTAL HIP ARTHROPLASTY WITH SUBTOCHANTERIC SHORTENING OSTEOTOMY IN HIGH DISLOCATION OF THE HIP, USING A TITANIUM MONOBLOCK TAPERED FLUTED STEM: A THREE- TO 20-YEAR FOLLOW-UP. A MULTICENTRE STUDY

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Aim

To assess the survivorship of a tapered fluted Titanium monoblock stem in conjunction with subtrochanteric shortening for patients with High Dislocation performed at 2 centres.

Methods

This was a retrospective study of 84 hips in 52 patients between two centres. All patients had a high dislocation. Thirty five patients had bilateral dysplasia. All patients had total hip arthroplasty with a subtrochanteric shortening osteotomy. The acetabular component was placed at the level of the anatomic hip centre. The femoral component was the “Wagner Cone prosthesis” which is a monoblock Titnium Alloy stem, tapered and fluted. The acetabular component varied. All patients had a follow up examination with a Harris Hip Score and a plain radiograph. The radiographs were assessed for osteotomy complications, change in stem position, evidence of loosening, heterotopic ossification & stress shielding if any. Notes were reviewed for complications.

Results

The mean age at operation was 55 yrs (range 20–83). The mean follow up was 9 years (range3–20). Eight patients were lost to follow up (16%). All the rest of the femoral components survived that were available for follow up −84% (worst case scenario). Six patients (7.8%) had an early complication that needed a reoperation. The Mean Harris Hip Score (HHS) improved from 42 points to 88 points.

Conclusion

The success rate of patients undergoing Cementless Arthroplasty using the Wagner cone stem in conjunction with a subtrochanteric shortening osteotomy is very high. The complication rate is however larger than in the normal population