Treatment of congenital dislocated hip by arthroplasty with femoral shortening

This was a retrospective study of 15 hips in 11 patients with complete cong enital dislocation of the hip treated by total hip arthroplasty and femoral shortening with a subtrochanteric double chevron derotation osteotomy, The mean age at the time of surgery was 51 years (range, 21-74 years), and the mean followup was 5.5 years (range, 2-8.5 years). Functional evaluation us ing the modified Harris hip rating system showed an excellent result in fiv e hips and a good result in seven hips (80% success rate). The location of the hip center was lowered by a mean of 8.3 cm (range, 5.7-10.4 cm), Leg le ngth discrepancy in seven patients with unilateral involvement was reduced from a mean of 3.9 cm (range, 1.7-8.2 cm) before surgery to a mean of 1.4 c m at the latest foIlowup (range, 0-4 cm), The Trendelenburg sign was assess ed in 10 of 15 hips and was corrected from a positive preoperative status t o a negative postoperative status in eight of these 10 hips. There were no cases of nonunion, dislocation, nerve palsy, or radiographic loosening. The only complications were a supracondylar fracture below the femoral compone nt in a patient with severe osteoporosis 6 months after surgery and looseni ng of the cemented titanium metal backed acetabular component in the same p atient 1.5 years after surgery. The current series showed that total hip ar throplasty in combination with a subtrochanteric double chevron derotation osteotomy has promising short to midterm results in the treatment of comple te congenital dislocation of the hip in adults.