Direct Leverage for Reducing the Femoral Head in Total Hip Arthroplasty Without Femoral Shortening Osteotomy for Crowe Type 3 to 4 Dysplasia of the Hip

作者：Li, Huiwu; Yuan, Yao; Xu, Jiawei; Chang, Yongyun; Dai, Kerong; Zhu, Zhenan^*

来源：Journal of Arthroplasty, 2018, 33(3): 794-799.

DOI：10.1016/j.arth.2017.09.011

• femoral head reduction
• high hip dislocation
• direct leverage
• total hip arthroplasty
• developmental dysplasia of the hip

Background: A number of methods for reduction in high hip dislocation in total hip arthroplasty (THA) are time-consuming and laborious, and require great surgical skills. This study aimed to introduce a new reduction technique to achieve rapid, safe, and easy reduction in high hip dislocation. @@@ Methods: We retrospectively reviewed 74 THA patients (82 hips; 44 women, 30 men) with severe hip dysplasia who underwent direct leverage using a Hohmann retractor into the anatomical acetabulum without femoral shortening osteotomy between September 2007 and January 2014. Forty-nine hips were classified as Crowe III and 33 hips were classified as Crowe IV. The mean follow-up period was 5.1 years (range 2-8). @@@ Results: Mean Harris Hip Score increased from 42.1 (range 24-71) before surgery to 89.9 (range 76-100) at final follow-up examination. The legs were lengthened by a mean of 3.0 cm (range 1.1-5.5) and 2.5 cm (range 1.1-3.5) in Crowe III hips and 3.6 cm (range 1.9-5.5) in Crowe IV hips postoperatively. The average leg-length discrepancy at the final follow-up examination was 0.4 cm (standard deviation 0.5 cm). One greater trochanteric fracture occurred during the hip reduction process. One patient developed femoral nerve palsies and recovered completely at 3 weeks postoperatively. @@@ Conclusion: Direct leverage using the Hohmann retractor for the reduction in high hip dislocation in THA without femoral shortening osteotomy is simple, safe, and effective.

• 出版日期2018-3
• 单位上海交通大学