Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for XXXX with developmental dysplasia.

@entity1 @entity86 @entity572 @entity912
BACKGROUND: The purpose of this retrospective study was to analyze the functional and radiographic results of cementless, modular total hip arthroplasty combined with subtrochanteric osteotomy for the treatment of @entity1 who had had Crowe Group-IV @entity572 as a @entity1 . METHODS: Twenty-five consecutive @entity1 (thirty-three @entity572 ) who had previously had Crowe Group-IV @entity572 were treated with a modular cementless prosthesis at a mean age of sixty years. The mean follow-up period was eight years (range, five to eleven years). The acetabular cup was placed in the position of the anatomical hip center in every @entity1 . Subtrochanteric femoral shortening osteotomy was performed with use of a step-cut design. RESULTS: The mean Merle d'Aubign   and Postel hip score improved from 9 to 16 points (out of a maximum of 18 points). The mean limb-length discrepancy in seventeen @entity1 with unilateral involvement was reduced from 5.1 cm (range, 3.7 to 6.5 cm) to 2.8 cm (range, 1.4 to 4.6 cm). Two @entity1 had a positive Trendelenburg sign, and three had a slight limp at the time of the latest follow-up. No cases of nonunion or nerve @entity912 were encountered. @entity86 occurred in two @entity572 . One hip showed progressive radiolucent lines around the proximal femoral sleeve within two years after the surgery, and this was followed by progressive stem subsidence. Only one femoral stem was revised. CONCLUSIONS: Cementless, modular total hip arthroplasty combined with subtrochanteric osteotomy for the treatment of @entity1 with prior Crowe Group-IV @entity572 resulted in satisfactory outcomes. Hips with poor bone quality and a developmentally short femoral neck present technical challenges with regard to achieving sufficient rotatory stability, following osteotomy, for osseointegration of the modular implants. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
