Oblique femoral shortening osteotomy in total hip arthroplasty for high dislocation in patients with hip dysplasia.

PURPOSE: The aim of this study was to evaluate outcomes after implantation of total hip arthroplasty for developmental dysplasia with high dislocation of the hip using conical stems combined with oblique subtrochanteric shortening osteotomy.

METHODS: We retrospectively reviewed the functional scores, radiographic results, and complications in a consecutive series of 16 hips (12 patients) with Crowe IV developmental dysplasia of the hip. The average age at surgery was 53.2 years and the patients were operated on between 1999 and 2008.

RESULTS: The average Harris Hip Score improved from 37.2 to 83.7 at a mean follow-up of 8.7 years. All acetabular cups were inserted into the true acetabulum and all prosthetic components were stable at the last follow-up visit. No neurovascular damage was recorded. Complications arose in six hips (37.5%): intra-operative fracture of proximal femur requiring fixation (n = 2); dislocation (n = 3); and asymptomatic non-union of the osteotomy (n = 1). The osteotomy healed within less than six months in all the remaining cases.

CONCLUSIONS: With the numbers given the oblique femur shortening osteotomy led to an increased rotational stability and proved to be a simple and effective method. Compared with transverse osteotomy and as related to our experience, this technique may be a method of choice in selected cases.