Meng Jiahong, Hu Bin, Yan Shigui, Liu An, Wu Haobo
Department of Orthopedics Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China; Orthopedics Research Institute of Zhejiang University, Hangzhou, PR China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou, PR China; Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, PR China.
J Arthroplasty. 2025 Aug 25. doi: 10.1016/j.arth.2025.08.051.
The aim of this study was to evaluate the safety and effectiveness of total hip arthroplasty (THA) without subtrochanteric osteotomy (STO) for patients who have Crowe type IV developmental dysplasia of the hip and to compare its clinical and radiological outcomes with subtrochanteric transverse shortening osteotomy.
We retrospectively analyzed 66 hips in 57 patients who underwent cementless THA for Crowe type IV developmental dysplasia of the hip. The patients were divided into two groups based on whether they underwent STO, with 31 hips in the nonosteotomy group and 35 hips in the STO group. The clinical outcomes, radiological findings, and complication rates were compared between the two groups.
The Harris Hip scores showed significant improvement in both groups. However, there were no differences in the improvement of Harris Hip scores or implant positioning between the treated groups. Compared to the STO group, the nonosteotomy group had a shorter operation time (P = 0.045) and a lower rate of blood transfusion (P = 0.028). We noted a smaller leg length discrepancy in the nonosteotomy group (8.3 mm) compared to the osteotomy group (18.1 mm) (P < 0.001). Although the incidence of limping was lower in the nonosteotomy group (18.5%) than in the STO group (40.0%), this difference was not statistically significant. No significant differences in complications were observed between the groups.
Both subtrochanteric shortening osteotomy and nonosteotomy techniques in THA provide satisfactory clinical outcomes. The nonosteotomy approach showed a shorter operative time, a lower rate of blood transfusions, and better control of leg length discrepancy, indicating that it is a simple, safe, and effective technique.
