Background: the purpose of this paper is to evaluate the functional and clinical results of the developmental high dislocated hips after subtrochanteric transverse shortening osteotomy fixed axially and rotationally by cementless femoral stem and the asetabular component placed into the anatomical place.

Methods: in a retrospective study, we evaluated the results and complications of twenty-four consecutive primary cementless total hip arthroplasty in eighteen patients (sixteen female and two male) all of whom had Crowe IV (Hartofilakidis type III) high dislocations. The arthroplasty was performed in combination with a subtrochanteric transverse shortening osteotomy and Zweymüller femoral stem(SL plus) without any fixation instruments for the osteotomy site and with placement of the acetabular component at the level of anatomic hip center. All of the patients were evaluated at a mean of 4 years postoperatively.

Results: the mean Harris Hip score increased from 17.25 points preoperatively to 84.87 points at the time of final follow up (p< 0.01). Seven of the twenty four hips had an early or late complications and/or reoperations. None of the subtrochanteric osteotomies were followed by non-union and no other complications concerning the femoral site is seen. There was one instance of isolated loosening of asetabuler component. Two hips dislocated postoperatively which were treated by closed reduction and bracing for 12 weeks. One siatic neurapraxic injury was identified which resolved within 6 months’ time. Intraoperative femoral cracks were seen in three hips. One of them on the proximal part (trochanteric site) and the other two on the distal femur. All were fixed by cerclage and cables without any further pain and complications.

Conclusions: subtrochanteric shortening osteotomy and cementless total hip arthoplasty for the treatment of developmental dysplasia and dislocations of the hip were associated with high rates of successful fixation of the femoral component and the asetabulum. The osteotomy site has a healing potential within the eight weeks’ time without any complications. The mean Harris hip score was 84.87 points. The complication rate is higher than that associated with primary total hip arthroplasty for the degenerative arthritis.

Introduction: This is a retrospective study to determine the effects of vertebroplasty and kyphoplasty on quality of life in multiple myeloma patients with spinal compression fractures.

Material and Methods: Thirty-four patients with primary multiple myeloma were treated for symptomatic compression fractures between June 2003 and June 2005. Kyphoplasty was applied to 22 levels in 18 and vertebroplasty to 28 levels in 16 patients.

The pain-related disability was evaluated for every single daily living activity using visual analog scale (VAS) over 10 points. (pain at rest, walking, sitting–standing, taking a shower and wearing clothes). (This evaluation is performed to every patient with degenerative disorders of the spine upon admission to our clinic.) Overall VAS scores were evaluated over 50 points (0 minimum, 50 maximum) preoperatively, at postoperative six weeks, six months and at one year prior to taking analgesics.

The amount of analgesic use was recorded. Data was analyzed statistically using variance analysis, Friedman’s multiple comparison test and Student’s t test.

Results: The mean overall pain score in the kyphoplasty group decreased from a preoperative value of 36 to 12.13 at the sixth postoperative week, to 8.63 at the sixth month and to 9.72 at one year. (p< 0.001).

The mean overall pain score in the vertebroplasty group decreased from a preoperative value of 37.83 to 15.33 at the sixth postoperative week, to 12.17 at sixth months and to 13.47 at one year. (p< 0.001).

Student’s t test was used to analyze the percentage of differences in overall pain score. Difference between groups was not statistically significant at the sixth week (p=0.106) but was statistically significant both at the sixth month (p=0.024) and at one year (p=0.027) in favor of kyphoplasty group.

No secondary collapse was observed in adjacent levels in both groups. There were no intrapostoperative neurologic/pulmonary complications in both groups. Analgesics usage significantly decreased in both groups.

Conclusion: In multiple myeloma, when pathological spinal compression fractures cause intractable pain and are unresponsive to conservative treatment, both vertebroplasty and kyphoplasty are effective in increasing quality of life and decreasing pain.