Partial greater trochanter osteotomy for hip reduction in total hip arthroplasty for high dislocated hip: a preliminary report

BMC Musculoskeletal Disorders

Kun Zheng Wang¹  Yao Jun Wu¹  Xiao Qian Dang¹  Qi Chun Song¹  Chuan Yi Bai¹  Rui Yu Liu¹ 

[1] Department of Orthopaedic, Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University, No.157, Xiwu Road, Xi’an 710004, Shaanxi, P. R. China

关键词: Total hip arthroplasty;    High dislocated hip;    Hip reduction;    Partial greater trochanter osteotomy;   

Others  :  1122148
DOI  :  10.1186/1471-2474-15-293

 received in 2014-05-08, accepted in 2014-08-28,  发布年份 2014

【 摘 要 】

Background

Hip reduction in total hip arthroplasty for high dislocated hips is difficult. Various femur osteotomy procedures have been used for hip reduction, but these methods increase operative time and risk of nonunion. We investigated the efficacy of a novel partial greater trochanter osteotomy technique for hip reduction in total hip arthroplasty for patients with high hip dislocation.

Methods

Twenty-one patients (23 hips) with high dislocated hip were treated with total hip arthroplasty that included partial greater trochanter osteotomy, i.e., the upper 2/3 greater trochanter was resected, and the gluteus medius muscle attachment was spared. The clinical outcome was evaluated by comparing the Harris hip scores and radiographic exam results, obtained before surgery and at follow-ups.

Results

Follow-ups of 21 patients ranged from 13 to 56 months. The mean Harris hip score increased from preoperative 55.0 (36–69) to postoperative 86.1 (71–93; P = 0.00). The average preoperative leg length discrepancy in patients with unilateral high hip dislocation was 46 mm (28–65 mm); postoperatively leg length discrepancy was less than 1 cm in 11 patients, between 1 and 2 cm in 8 patients, and more than 2 cm in 2 patients. The average leg lengthening at the time of surgery was 36 mm (24–54 mm). Trendelenburg’s gait changed from positive to negative in 20 hips by the last follow-up. No nerve injury occurred postoperative.

Conclusion

Partial greater trochanter osteotomy is an effective method to render hip reduction in total hip arthroplasty for patients with high dislocation of the hip.

【 授权许可】

   
2014 Liu et al.; licensee BioMed Central Ltd.

【 图 表 】

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