Results of total hip arthroplasty with subtrochanteric oblique shortening osteotomy technique for crowe TYPE İV developmental dysplasia of the hip

Objective: The aim of this study is to evaluate the long-term results of cementless total hip arthroplasty combined with subtrochanteric oblique shortening osteotomy for Crowe type IV dysplasia hip joints, also known as high hip dislocation. Methods: We retrospectively evaluated 52 hip joints of 40 patients who underwent subtrochanteric oblique shortening osteotomy and simultaneous cementless total hip arthroplasty in terms of functional scores, complications, and radiographic results. All patients had preoperative Crowe IV (high hip dysplasia) joint. 34 of the patients were female and 6 were male. The mean age was 54.3. The mean follow-up period was 108.2 months. We used metal-polyethylene combination in 24 hips, ceramic-ceramic in 16 hips, and metal-metal combination in 12 hips as joint surface combination. Mostly rectangular femoral stems were used. Results: Harris hip score increased from 43.5 to 89.2 on average. The mean relative outcome value in the Merle d'aubigne-Postel hip score was 13.6. Similarly, there was a significant improvement in hip disability and osteoarthritis outcome score, joint replacement test scores with the SF-12 test. The mean distalization of the trochanter major was 7.2 cm. The mean time to union of the osteotomy was 4.1 months. The rate of the revised hip was 23.1%. Nonunion in the osteotomy line was seen in 5.8%, intraoperative fracture in 36.5% and postoperative dislocation in 13.5%. Permanent nerve damage developed in 2 patients. Acetabular inclination was 54.1 degrees on average. 87.5% of hips with a ceramic-ceramic joint surface combination had no implant revision surgery. Trendelenburg test positivity was 26.9% at the last control. Conclusion: Simultaneous cementless total hip arthroplasty with oblique shortening osteotomy is a satisfactory and effective treatment for adult high hip dysplasia.