The Journal of Bone and Joint Surgery (American). 2005;87:339-345.
doi:10.2106/JBJS.D.02097
© 2005 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activity for this article:
 Adult Hip Reconstruction Test 13: Spring 2005
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lai, K.-A.
Right arrow Articles by Chen, M.-Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lai, K.-A.
Right arrow Articles by Chen, M.-Y.
Related Collections
Right arrow Adult Hip
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Cementless Total Hip Arthroplasty and Limb-Length Equalization in Patients with Unilateral Crowe Type-IV Hip Dislocation

Kuo-An Lai, MD1, Wun-Jer Shen, MD2, Lee-Wen Huang, MD1 and Meng-Yi Chen, MD3

1 Department of Orthopaedics, National Cheng Kung University Medical Center, No. 138, Sheng-Li Road, Tainan, Taiwan. E-mail address for K.-A. Lai: laikuoan{at}mail.ncku.edu.tw
2 Po-Cheng Orthopaedic Institute, No. 100, Po-Ai 2nd Road, Kaohsiung 813, Taiwan
3 Peikang Ma-Tsu Hospital, No. 123, Shin-Do Road, Peikang, Yun-Lin County, Taiwan

Investigation performed at the Department of Orthopaedics, National Cheng Kung University Medical Center, Tainan, Taiwan

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Total hip arthroplasty in patients with unilateral congenital high dislocation of the hip (Crowe type IV) presents many challenges, including the problem of a marked limb-length discrepancy. The purpose of this retrospective study was to analyze the results of total hip replacement with limb-length equalization in these patients.

Methods: From 1988 to 1996, fifty-six patients (forty-seven women and nine men) with unilateral Crowe type-IV dislocation of the hip were treated with a cementless total hip arthroplasty at a mean age of 35.4 years. The preoperative limb-length discrepancy averaged 4.9 cm. Prior to the total hip arthroplasty, forty-eight patients with a limb-length discrepancy of >4.0 cm underwent iliofemoral distraction with use of an external fixator for eight to seventeen days. The acetabular cup was placed in the anatomical position in every patient. Shortening femoral osteotomies were not required.

Results: The iliac fixator pins loosened in six patients. No patient had a pin-site infection, hip joint infection, or nerve palsy. At the time of follow-up, at an average of 147.2 months, the Harris hip score averaged 90.2 points. Overall, the mean lengthening after the total hip arthroplasty was 4.6 cm. There were no revisions of the femoral stem. Nine cups were revised, four because of polyethylene wear and five because of loosening.

Conclusions: We were able to safely place the acetabular cup at the anatomical position without femoral shortening by bringing the femoral head to the normal level preoperatively; thus, we could restore nearly normal limb length. We believe that our twelve-year results are similar to those of total hip arthroplasty in patients without dysplasia.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
A. J. Krych, J. L. Howard, R. T. Trousdale, M. E. Cabanela, and D. J. Berry
Total Hip Arthroplasty with Shortening Subtrochanteric Osteotomy in Crowe Type-IV Developmental Dysplasia
J. Bone Joint Surg. Am., September 1, 2009; 91(9): 2213 - 2221.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
R. A. Butler, J. R. Hsu, and R. L. Barrack
Use of an Ilizarov Apparatus to Perform Closed Reduction of a Chronic Proximal Dislocation Following Total Hip Arthroplasty. A Case Report
J. Bone Joint Surg. Am., February 1, 2006; 88(2): 411 - 414.
[Full Text] [PDF]