Cementless Ceramic-On-Ceramic THA Performed with Transverse
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Total hip arthroplasty (THA) performed for developmental dysplasia of the hip (DDH) is a technically difficult procedure with a high complication rate, especially in the presence of completely dislocated hips. This study aimed to evaluate the results of at least 10 years of follow-up results of cementless, ceramic-on-ceramic (CoC) total hip arthroplasty performed with transverse subtrochanteric osteotomy in Crowe type 4 hips.

Researchers evaluated 67 hips from 50 patients who had CoC, cementless THA, and transverse subtrochanteric osteotomy. The hips clinical and radiological data were reviewed. The Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index were used to assess clinical outcomes (WOMAC).

Results:
--The mean HHS improved from 22.9 ± 9.9 preoperatively to 94.1±8.1 at final follow-up. The median WOMAC score improved from 72 (IQR:17) preoperatively to 2 (IQR:17) postoperatively.

--The preoperative mean leg length discrepancy (LLD) was improved 4.9 ± 1 cm to 1.5 ± 1 cm in unilateral cases at the last follow-up.

--Revision surgery was required due to non-union in two patients, prosthetic infection in one patient and aseptic femoral loosening in the other patient.

--The overall ten-year survival rate was 94% for femoral stems and 98.5% for acetabular components according to Kaplan-Meier survival analysis.

Conclusively, transverse subtrochanteric shortening osteotomy combined with using cementless acetabular and femoral components with a CoC bearing surface promises successful clinical results and high prosthesis survival in the treatment of Crowe 4 hips at long-term follow-up.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540321005180?dgcid=rss_sd_all
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