Wagner cone股骨柄联合转子下横形截骨的全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良

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Abstract Objective To analyze the clinical outcome and complications of total hip arthroplasty(THA) with Wagner Cone stem and transverse subtrochanteric osteotomy in treatment of Crowe type iv Developmental Dysplasia of the Hip(DDH).Methods 51 patients(67 hips) underwent THA with Wagner Cone stem and transverse subtrochanteric osteotomy from January，2009 to December，2015 were included in our study.There were 44 women and 7 men.The age was 16 to 65，with an average age of 40 years.All the patients were diagnosed as Crowe type Ⅳ DDH.The clinical function of the patients was evaluated by Harris Hip joint score and AP pelvic view and fulllength view of the lower extremities were used to evaluate the position of prosthesis，the healing of osteotomy，the osteolysis and the sinking of prosthesis.Results The average duration of follow-up was 54 months(Range 24~108 months).The mean Harris hip score was improved from 37.5(range：30~55) preoperatively to 85.8 postoperatively(range：78~96)，and there were statistically significant differences in Harris hip score(P＜0.05).Mean leg-length discrepancy had decreased from 3.8 cm(range，0~8 cm) preoperatively to 0.8 cm(range，0~1.5 cm) by the latest follow-up evaluation.Femoral shortening subtrochanteric osteotomy was performed with an average femoral resection of 3.1 cm(range：1.5~6.5 cm).There were 3 cases of intraoperative fracture，5 cases of postoperative dislocation，1 case of nonunion(2 hips)，without infection，nerve palsy，prosthesis loosening and sinking.Conclusion Total hip arthroplasty with Wagner Cone stem and transverse subtrochanteric osteotomy for Crowe Ⅳ developmental dysplasia of the hip can obtain satisfactory clinical outcomes with less complications and effectively balance the length of two lower limbs and simplify the complexity of the operation.

Key words： total hip arthroplasty treatment outcome transverse subtrochanteric osteotomy stem of hip prosthesis developmental dysplasia of the hip

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