Comparative Assessment of Subtrochanteric Shortening Osteotomy and Paavilainen’s Proximal Osteotomy in Total Hip Arthroplasty for Crowe III–IV Dysplasia

封面


如何引用文章

全文:

详细

The purpose of the study — to compare the results of the subtrochanteric shortening osteotomy and Paavilainen proximal osteotomy in the total hip arthroplasty for Crowe III and IV dysplasia. Material and Methods. It was performed 36 hip arthroplasties in the patients with Crowe III (12) and IV (24) dysplasia. Two methods of the shortening osteotomy were used: Paavilainen osteotomy (22) and subtrochanteric osteotomy (14). The average follow-up was 42.3±22.7 months (from 6 to 88). Among the patients, there were 25 (75.8%) women and 8 (24.2%) men with the average age of 51.5±13.1 and 34.6±20.4 years, respectively. Results. The lateral acetabular deficiency required the structural repair of the femoral head in 16.7% of the cases. The average length of the osteotomized fragment was 56.8±16.3 mm, the caudal displacement of the greater trochanter apex — 47.0±15.6 mm, the limb lengthening — 30.1±10.9 mm without the statistically significant difference between the groups. The consolidation was achieved on average in 7 months. The Harris score improved on average from 37.6±10.1 points to 76.1±17.6, p<0.001 (78.1±15.3 in Paavilainen group and 72.9±20.9 in the subtrochanteric). The overall HOOS score increased from an average of 34.6±12.4 to 74.6±18.6 points, p<0.001 (78.1±15.9 in Paavilainen group and 69.1±21.7 in the subtrochanteric). The statistically significant differences between the groups after the surgery were found only in the HOOS pain section. Paavilainen group showed higher scores. Various postoperative complications occurred in 27.8% of cases, 2.4 times more often in the subtrochanteric group. The revision was required in 4 cases out of 36 (11.1%): 2 cases (9.1%) in Paavilainen group and 2 cases (14.3%) in the subtrochanteric. The survival rate of the femoral component throughout the sample was 97.2%. There was only one case of the femoral component replacement in the subtrochanteric group. Conclusion. Both the subtrochanteric shortening osteotomy and Paavilainen proximal osteotomy have good reconstructive capabilities and sufficient efficacy. We were not able to identify the clear advantages of any of the described options for shortening osteotomy, probably due to the insufficient number of observations. In our practice, we give a preference to subtrochanteric shortening osteotomy of the femur.

作者简介

A. Korytkin

Tsivyan Novosibirsk Scientific Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Andrey A. Korytkin — Cand. Sci. (Med.), Director

Novosibirsk

俄罗斯联邦

S. Gerasimov

Research Medical University of Volga Region

Email: fake@neicon.ru

Sergey A. Gerasimov — Head of Adult Orthopedics Department

Nizhny Novgorod

俄罗斯联邦

Ya. Novikova

Research Medical University of Volga Region

编辑信件的主要联系方式.
Email: novikova_jana@mail.ru

Yana S. Novikova — Cand. Sci. (Biol.), Junior Researcher

Nizhny Novgorod

俄罗斯联邦

K. Kovaldov

Research Medical University of Volga Region

Email: fake@neicon.ru

Kirill A. Kovaldov — PhD Student, Orthopedic Surgeon

Nizhny Novgorod

俄罗斯联邦

E. Morozova

Research Medical University of Volga Region

Email: fake@neicon.ru

Ekaterina A. Morozova — Social Work Specialist

Nizhny Novgorod

俄罗斯联邦

S. Korolev

Research Medical University of Volga Region

Email: fake@neicon.ru

Svyatoslav B. Korolev — Dr. Sci. (Med.), Professor, Head of Traumatology, Orthopedics and Military Field Surgery Department, Orthopedic Surgeon

Nizhny Novgorod

俄罗斯联邦

Yo. El moudni

Ibn Rochd University Hospital

Email: fake@neicon.ru

Junes M. El Mudni — Orthopaediс Surgeon

Casablanca

摩洛哥

参考

  1. Zhen P., Liu J., Lu H., Chen H., Li X., Zhou S. Developmental hip dysplasia treated by total hip arthroplasty using a cementless Wagner cone stem in young adult patients with a small physique. BMC Musculoskelet Disord. 2017;18(1):192. doi: 10.1186/s12891-017-1554-9.
  2. Lai K.A. Developmental dysplasia and dislocation of the hip in adults. Singapore: Springer; 2018. 117 p. doi: 10.1007/978-981-13-0414-9.
  3. Grappiolo G., La Camera F., Della Rocca A., Mazziotta G., Santoro G., Loppini M. Total hip arthroplasty with a monoblock conical stem and subtrochanteric transverse shortening osteotomy in Crowe type IV dysplastic hips. Int Orthop. 2019;43:77-83. doi: 10.1007/s00264-018-4122-5.
  4. Necas N., Hrubina M., Melisik M., Cibula Z., Chmurny M., Daniel M., Steno B. Cementless hip arthroplasty and transverse shortening femoral osteotomy with the S-ROM stem for Crowe type IV developmental dysplasia. Eur J Orthop Surg Traumatol. 2019;29(5):10251033. doi: 10.1007/s00590-019-02400-y.
  5. Sofu H., Kockara N., Gursu S., Issin A., Oner A., Sahin V. Transverse subtrochanteric shortening osteotomy during cementless total hip arthroplasty in Crowe type-III or IV developmental dysplasia. J Arthroplasty. 2015;30(6):1019-1023. doi: 10.1016/j.arth.2015.01.045.
  6. Desteli E.E., Imren Y., Tan E., Erdoğan M., Özcan H. Clinical results of cementless total hip arthroplasty with shortening osteotomy for high dislocation with developmental dysplasia. Acta Orthop Belg. 2015;81(1):30-35.
  7. Rollo G., Solarino G., Vincenti G., Carrozzo M., Moretti B. Subtrochanteric femoral shortening osteotomy combined with cementless total hip replacement for Crowe type IV developmental dysplasia: a retrospective study. J Orthop Traumatol. 2017;18(4):407-413. doi: 10/1007/s10195-017-0466-7.
  8. Тихилов Р.М., Шубняков И.И. Руководство по х гии тазобедренного сустава. СПб; 2015. Т. II. с. 20-54.
  9. Тихилов Р.М., Мазуренко А.М., Шубняков И.И., Денисов А.О., Близнюков В.В., Билык С.С. Результаты эндопротезирования тазобедренного сустава с укорачивающей остеотомией по методике T. Paavilainen при полном вывихе бедра. Травматология и ортопедия России. 2014;(1):5-15. doi: 10.21823/2311-2905-2014-0-1-5-15.
  10. Павлов В.В., Шнайдер Л.С., Голенков О.И. Алгоритм выбора метода обработки бедренной кости при эндопротезировании тазобедренного сустава на фоне дисплазии Crowe IV ст. Современные проблемы науки и образования. 2016;(6). Режим доступа: https://science-education.ru/ru/article/view?id=25600.
  11. Wang D., Li D.H., Li Q., Wang H.Y., Luo Z.Y., Yang Y. et al. Subtrochanteric shortening osteotomy during cementless total hip arthroplasty in young patients with severe developmental dysplasia of the hip. BMC Musculoskelet Disord. 2017;18(1):491. doi: 10.1186/s12891-017-1857-x.
  12. Тряпичников А.С., Камшилов Б.В., Чегуров О.А., Зайцева О.П., Ермаков А.М. Некоторые аспекты эндопротезирования тазобедренного сустава с подвертельной укорачивающей остеотомией при врожденном вывихе бедра (обзор литературы). Травматология и ортопедия России. 2019;25(1):165-176. doi: 10.21823/2311-2905-2019-25-1-165-176.
  13. Камшилов Б.В., Тряпичников А.С., Чегуров О.К., Жданов А.С., Зайцева О.П. Особенности эндопротезирования тазобедренного сустава у пациентов с высоким врожденным вывихом бедра. Травматология и ортопедия России. 2017;23(4):39-47. doi: 10.21823/2311-2905-2017-23-4-39-47.
  14. Crowe J.F., Mani V.J., Ranawat C.S. Total hip r ment in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61(1):15-23.
  15. Hartofilakidis G., Yiannakopoulos C.K., Babis G.C. The morphologic variations of low and high hip dislocation. Clin Orthop Relat Res. 2008;466(4):820-824. doi: 10.1007/s11999-008-0131-9.
  16. Harris W.H. Traumatic arthritis of the hip after d tion and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-755. doi: 10.2106/00004623-196951040-00012.
  17. Huskisson E.C. Measurement of pain. Lancent. 1974;304:1127-1131.
  18. Klassbo M., Larsson E., Mannevik E. Hip d ity and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol. 2003;32(1): 46-51. doi: 10.1080/03009740310000409.
  19. Ozan F., Uzun E., Gürbüz K., Koyuncu Ş., Altay T., Kayali C. Total hip arthroplasty in the development dysplasia of the hip using transverse subtrochanteric osteotomy. J Orthop. 2016;13(4):259-263. doi: 10.1016/j.jor.2016.06.010.
  20. Лоскутов О.А. Эндопротезирование тазобедренного сустава при вывихе бедра диспластического генеза. Ортопедия, травматология и протезирование. 2016;(4):84-89. doi: 10.15674/0030-59872016484-89.
  21. Rasi A.M., Kazemian G., Khak M., Zarei R. Shortening subtrochanteric osteotomy and cup placement at true acetabulum in total hip arthroplasty of Crowe III-IV developmental dysplasia: results of midterm followup. Eur J Orthop Surg Traumatol. 2018;28(5):923-930. doi: 10.1007/s00590-017-2076-8.
  22. Greber E.M., Pelt C.E., Gililland J.M., Anderson M.B., Erickson J.A., Peters C.L. Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip. J Arthroplasty. 2017;32:S38-S44. doi: 10.1016/j.arth.2017.02.024.
  23. Машков В.М., Карелкин В.В., Денисов А.О. Отдаленный результат эндопротезирования тазобедренных суставов по методу T. Paavilainen при врожденном вывихе бедра. Избранные вопросы хирургии тазобедренного сустава: сборник научных статей. 2016:190-195. Режим доступа: https://elibrary.ru/item.asp?id=28917235.
  24. Sakellariou V.I., Christodoulou M., Sasalos G., Babis G.C. Reconstruction of the acetabulum in developmental dysplasia of the hip in total hip replacement. Arch Bone Joint Surg. 2014;2(3):130-136.
  25. Корыткин А.А., Смирнов А.А., Захарова Д.В., Новикова Я.С., Ковалдов К.А., Эль Мудни Ю.М. Опыт использования аппаратов внешней фиксации в условиях ригидных деформаций тазобедренного сустава на этапе предоперационной подготовки и планирования сложных случаев первичного и ревизионного эндопротезирования. Гений ортопедии. 2018;24(1):18-23. doi: 10.18019/1028-4427-2018-24-1-18-23.
  26. Bicanic G., Barbaric K., Bohacek I., Aljinovic A., Delimar D. Current concept in dysplastic hip arthroplasty: techniques for acetabular and femoral reconstruction. World J Orthop. 2014;5(4):412-424. doi: 10.5312/wjo.v5.i4.412.
  27. Kawai T., Tanaka C., Kanoe H. Total hip arthroplasty for Crowe IV hip without subtrochanteric shortening osteotomy — a long term follow up study. BMC Musculoskelet Disord. 2014;15:72. doi: 10.1186/1471-2474-15-72.
  28. Ollivier M., Abdel M.P., Krych A.J., Trousdale R.T., Berry D.J. Long-term results of total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe IV developmental dysplasia. J Arthroplasty. 2016;31(8):1756-1760. doi: 10.1016/j.arth.2016.01.049.
  29. Машков В.М., Долгополов В.В., Шильников В.А., Денисов А.О. Результаты эндопротезирования при двустороннем врожденном вывихе бедра. Современные проблемы науки и образования. 2017;(5). Режим доступа: https://science-education.ru/ru/article/view?id=26989.
  30. Muratli K.S., Karatosun V., Uzun B., Celik S. Subtrochanteric shortening in total hip arthroplasty: biomechanical comparison of four techniques. J Arthroplasty. 2014;29(4):836-842. doi: 10.1016/j.arth.2013.09.004.
  31. Güçlü B. Cementless total hip arthroplasty with transverse subtrochanteric shortening osteotomy in developmental high dislocated hips and minimum 6 years follow-up. Ann Orthop Surg Res. 2019;2(1): 1007.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © ,


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


##common.cookie##