고위 고관절 탈구에서 대퇴골 단축을 시행하지 않은 고관절 전치환술

Abstract

Purpose: This study evaluated the results of total hip arthroplasty (THA) without a femoral shortening procedure for the treatment of a highly dislocated hip. Materials and Methods: A total of 11 hips of 11 patients who underwent THA between April 1996 and February 2001 were clinically and radiologically evaluated. Among these 11 hips, 5 hips were sequelae of developmental dysplasia of the hip and 6 hips were sequelae of pyogenic or tuberculous infection. The mean follow-up period was 98 months (range: 88~121 months). Results: In all cases, the hip center was restored to the anatomic hip center. The mean Harris hip score increased from 56.2 preoperatively to 86.3 at the end of follow-up and the mean difference of the spino-malleolar distance decreased from 5.6 cm preoperatively to 1.4cm postoperatively. Non-union in the greater trochanter osteotomy site was encountered in two patients. Two cases of sciatic nerve palsy and one cases of heterotopic ossification occurred, but one case of sciatic nerve palsy recovered within 6 months. Conclusion: After enough soft tissue release, if reduction to the original hip center is difficult, then performing femoral osteotomy or shortening osteotomy should be considered during the THA for a highly dislocated hip.