SUBTROCHANTERIC FEMORAL SHORTENING OSTEOTOMY IN TOTAL HIP-ARTHROPLASTY FOR HIGH-RIDING DEVELOPMENTAL DISLOCATION OF THE HIP

A surgical technique, which uses a transverse osteotomy, for subtrocha nteric femoral shortening and derotation in total hip arthroplasty for high-riding developmental dislocation of the hip is described. Anteve rsion is set by rotating the osteotomy fragments, and torsional stabil ity is augmented with allograft struts and cables when indicated. Eigh t patients with 9 total hip arthroplasties were followed for an averag e of 43 months (range, 24-84 months). Good to excellent results were o btained in 87% of patients (7 of 8). Eight of 9 osteotomies (89%) demo nstrated radiographic evidence of healing at an average of 5 months. O ne patient had an asymptomatic nonunion of the osteotomy site but stil l had a good overall clinical result. Another patient suffered fatigue failure of a distally ingrown porous device, which necessitated revis ion total hip arthroplasty 18 months after surgery. Subtrochanteric os teotomy in total hip arthroplasty for developmental dislocation of the hip allows for acetabular exposure and diaphyseal shortening while fa cilitating femoral derotation. Furthermore, proximal femoral bone stoc k is maintained and some of the potential complications of greater tro chanteric osteotomy may be avoided.