Short-term Follow-up Of Total Hip Arthroplasty Combined With Bulk Structural Autogenous Grafts And Intertrochanteric Osteotomy For Crowe Type Ⅳ Developmental Dysplasia Of The Hip

Objective To evaluate the efficacy of total hip arthroplasty(THA)combined with bulk structural autogenous grafts and intertrochanteric osteotomy for Crowe type Ⅳ developmental dysplasia of the hip(DDH).Methods We retrospectively studied 48 patients(48 hips)with Crowe Ⅳ DDH between 2010 and 2013.All patients were performed THA with S-ROM non-cement femoral stem prosthesis.Acetabular were treated with autologous femoral bone structural bone grafting fixed with 2~3 hollow tension screw,and femur were treated with subtrochanteric shortening.Record intraoperative osteotomy length,intraoperative bleeding and blood transfusion cases,intraoperative cases of distal femoral fractures,femoral nerve injury and the incidence of venous thrombosis after operation,postoperative prosthesis loosening,periprosthetic fracture and infection cases.Compare the data from preoperation and postoperation including Harris score,VAS score and the lower limb length differences.SPSS 22 statistical software was used to analysis the results.Results 2 cases of patients with distal femoral fractures,the fractures healed with steel wire banding 3 months postoperative.3 cases of patients with postoperative femoral nerve injury symptoms,the symptoms were disappeared 1 months postoperative.Average preoperative length shortening of the affected limb was(6.3 0.9cm,and the Harrishipscore were(38.6 5.3).The duration of follow-up was 2 years。At last follow-up,average postoperative length shortening of the affected limb was(1.9 0.7cm),and the Harris hip score were(89.2 1.4);showing statistically differences(P<0.05)when compared with preoperation.During the follow-up period,all patients had no prosthesis loosening or infection,and no fracture around the prosthesis.Conclusion THA combined with bulk structural autogenous grafts and intertrochanteric osteotomy for Crowe DDH can obtain favorable results Ⅳ,and may be worth further investigation.