Experience about surgical treatment on 28 cases in congenital hip dislocation
and severe dysplasia, surgical treatment by descent and total replacement on one stage.
Follow-up: Minimum: 1 year. Maximum: 18 years. The indication constituted the 2.3% of THR
made in this period in front of great pain and disability ( important knee and lumbar
pain), instability evolution and genu valgus. We don't indicate it in claudication or
shortening.
Surgical
Technique
Adductor tenothomy.
Throcanter ostheotomy.Tenothomy psoas tendon and major gluteus. Femoral liberation and
descent. Set up prosthetic acetabulum in the original place, use of femoral head as iliac
graft. We don't make femoral shortening ostheotomy. Prosthetis used: Charnley: 19 cases -
Hybrid: 6 cases - Non cemented: 3 cases.
Main problem
Very sthenotic
femurs, for which we propose widening longitudinal ostheotomy and morsellized allograft
inside and structural board outside. Complications
Most frequent:
femoral fracture. no vascular - nervous complications; revisions - fracture, instability,
loosening: 3 cases up to date.
Results
Very good: 17 cases
Fair: 7 cases
Bad: 4 cases
Conclusions
THR is a satisfactory
solution in this pathology when surgery is the only alternative in front of great pain and
disability. Patient must be informed about the complexity of the proceeding.
IMAGES
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