Some Aspects of Total Hip Replacement with Subtrochanteric Shortening Osteotomy in Patients with Congenital Hip Dislocation (Review)

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Total hip replacement (THR) in patients with a high congenital dislocation of the hip (Crowe type IV dysplasia in Crowe classification) is a technically difficult operation, associated with a high risk of complications. The most common variations of THRs used to restore the true center of rotation of the hip are subtrochanteric shortening osteotomy and proximal shortening osteotomy using the Paavilainen technique. Numerous publications refer to the technique and outcomes of subtrochanteric osteotomy, but fundamental differences of opinion persist on a number of points relating to the topic.

The objective of the study is to analyze the publications on the treatment for crowe type IV hip dislocations using total replacement of the hip joint (HJ) with subtrochanteric shortening osteotomy.

The hypothesis of the study was as follows: the method of fixation of the femoral component, the type of osteotomy and the design features of the implant (philosophy) are the factors that determine the effectiveness of the operation. The electronic databases eLIBRARY and PubMed were searched for publications containing keywords in Russian or English: high dislocation of the hip, total replacement of the Hj, shortening subtrochanteric osteotomy. As a result of the study, the proposed hypothesis was partially confirmed. There were only minor differences in the overall incidence of complications and the survivorship of implants when using different types of cementless stems. The incidence of non-unions after the installation of cemented femoral components was higher than with the implantation of cementless. We did not find convincing evidence of the advantage of the step-cut, V-shaped and oblique osteotomies compared with the transverse osteotomy. Typical complications for such operations were the nerve injuries, intraoperative hip fractures, dislocations and non-unions of the femur at the osteotomy site.

作者简介

A. Tryapichnikov

Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»

编辑信件的主要联系方式.
Email: pich86@bk.ru

Aleksandr S. Tryapichnikov — cand. Sci. (Med.),junior researcher, Laboratory for Reconstructive J oint Replacements and Arthroscopy.

Kurgan 俄罗斯联邦

B. Kamshilov

Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»

Email: fake@neicon.ru

Boris V. Kamshilov — cand. Sci. (Med.), head, Department of Traumatology and orthopedics N 7.

Kurgan

俄罗斯联邦

O. Chegurov

Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»

Email: fake@neicon.ru

Оleg K. Chegurov — Dr. Sci. (Med.), head, Department of Traumatology and orthopedics N 16.

Kurgan

俄罗斯联邦

O. Zaytseva

Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»

Email: fake@neicon.ru

Olga P Zaytseva — cand. Sci. (Med.), orthopedic surgeon, Department of Traumatology and orthopedics N 7.

Kurgan

俄罗斯联邦

A. Ermakov

Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»

Email: fake@neicon.ru

Artem M. Ermakov — cand. Sci. (Med.), orthopedic surgeon, Bone Infection Department N 1.

Kurgan

俄罗斯联邦

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