The Journal of Bone and Joint Surgery, Vol 62, Issue 8 1351-1361, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Greater trochanteric hip arthroplasty in children with loss of the femoral head
AE Freeland, DJ Sullivan and GW Westin
In seventeen children with catastrophic loss of the femoral head, the hip
was salvaged by greater trochanteric arthroplasty. The average follow-up of
these patients was eleven years, and fourteen patients were followed to
skeletal maturity or longer. In Group I, consisting of four patients with
greater trochanteric arthroplasty alone, good initial stability gradually
deteriorated as subluxation occurred, accompanied by a proportionate return
of abductor limp, loss of hip motion, and an increased rate of degenerative
changes in the joint. Group II, consisting of eight patients who had either
acetabuloplasty or innominate osteotomy in addition to greater trochanteric
arthroplasty, had only slightly improved hip containment and results
similar to those in Group I. Spontaneous ankylosis of the hip occurred in
six of the patients in those two groups. The best results were obtained in
five patients in Groups III and IV who had the procedure supplemented by
proximal femoral varus osteotomy.