Controlled femoral impaction for reduction of hip arthroplasty in high riding hips: Is it safe?

Abstract

Background: The subtrochanteric femoral shortening osteotomy (SFO) is a complex surgical procedure. The aim of this study was to describe the novel controlled femoral impaction technique as a safe reduction method to avoid SFO during total hip arthroplasty (THA) and present its results in high dislocated hip patients who undergo THA. Materials and Method: This retrospective study included 40 Crowe developmental dysplasia of the hip (DDH) type III/IV patients for whom SFO was not planned in preoperative templating. Patients who were expected to have >4cm lengthening according to the preoperative templating are excluded. Patients were evaluated in respect of functional results with Harris Hip Score (HHS), limb length discrepancy (LLD) and complications. Of the 40 DDH patients who underwent THA without femoral shortening, controlled femoral cracking was performed in 20 cases while no additional procedure was required in 20 cases. Results: There were 3 male and 37 female patients with a mean age of 53.7±9.54 years. The mean follow-up period was 38±6.54 months (range, 24-66 months). The mean Harris Hip Score (HHS) was 45.96 (range, 38-72) preoperatively and 89.44±6.4 (range, 84-99) postoperatively. LLD was 3.4±0.7 (range, 0-4 cm) cm preoperatively and 0.7±0.5 cm (range, 0-2 cm) postoperatively (p