Joint replacement in patients with consequence of non-reduced hip joint fracture-dislocations

Authors

DOI:

https://doi.org/10.15674/0030-59872017278-83

Keywords:

fracture-dislocation, external fixation device, joint replacement, hip joint

Abstract

Joint replacement with the consequences of non-reduced hip fracture-dislocation is complex surgical intervention.

Objec­tive: to develop a technique for hip arthroplasty and to evalu­ate its results in patients with consequences of hip fracture-dislocation.

Methods: from 2004 to 2016 10 patients (10 joints) with the consequences of hip fracture-dislocation underwent total hip arthroplasty. The average age of the patients was 41.3 years (from 22 to 59), 5 men and 5 women. The shortening of the affected limb was on average 4.7 cm (2 to 8). In 5 patients, a reduction of the proximal femur with the external fixation de­vice in the «pelvic floor» system was performed before joint re­placement. The time of distraction and fixation in external fixa­tion device was on the average 55 days (from 21 to 98). The acetabular component of the endoprosthesis was set in the anatomi­cal position. Plastic defects in the acetabulum were carried out in 8 cases. Patients follow-up was from 6 month to 12 years.

Results: the functional state of hip joint by the Harris score in­creased from 30 to 82 points. Patients with X-ray signs of in­stability of the endoprosthesis components were not identified. Complete restructuring of autograft was carried out in 100 % of cases. Complications related to external fixation device: 1 case — superficial soft tissue infection around the pin, 1 — fracture of the pin, 1 — early periprosthetic infection, 1 — re­current dislocation.

Conclusions: the restoration of the hip joint rotation center and the length of the affected limb due to the use of the «pelvis – femur» external fixation device before joint repllacement, the reconstruction of the acetabular wall, taking into account the type of defect and the anatomical position of the endoprosthesis cup, allowed to minimize complications and obtain positive results in patients with consequences of hip fracture-dislocation.

Author Biographies

Volodymyr Filipenko

Sytenko Institute of Spine and Joint Pathology, Kharkiv. Ukraine

MD, Prof. in Orthopaedics and Traumatology

filippenko1957@gmail.com

 

Stanislav Bondarenko

Sytenko Institute of Spine and Joint Pathology, Kharkiv. Ukraine

PhD n Orthopaedics and Traumatology

bondarenke@gmail.com

 

 

Sergey Khmyzov

Sytenko Institute of Spine and Joint Pathology, Kharkiv. Ukraine

MD, Prof. in Orthopaedics and Traumatology

s.khmyzov@gmail.com

 

Anatoliy Zhygun

Sytenko Institute of Spine and Joint Pathology, Kharkiv. Ukraine

MD

anzhigun54@gmail.com

 

Anastasia Panchenko

Sytenko Institute of Spine and Joint Pathology, Kharkiv. Ukraine

anastasya_doctor@ukr.net

 

 

References

  1. Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N. Congenital hip disease in adults: classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am. 1996;78(5):683–92.
  2. Hartofilakidis G, Stamos K, Karachalios T. Treatment of high dislocation of the hip in adults with total hip arthroplasty: operative technique and long-term clinical results. J Bone Joint Surg. Am. 1998;80(4):510–17.
  3. Holinka J, Pfeiffer M, Hofstaetter JG, Lass R, Kotz RI, Giurea A. Total hip replacement in congenital high hip dislocation following iliofemoral monotube distraction. Int. Orthop. 2011;35(5):639–45. doi: 10.1007/s00264-010-1001-0.
  4. Lai KA, Shen WJ, Huang LW, Chen MY. Cementless total hip arthroplasty and limb-length equalization in patients with unilateral Crowe type-IV hip dislocation. J Bone Joint Surg Am. 2005;87(2):339–45. doi: 10.2106/JBJS.D.02097.
  5. Girdlestone GR. Acute pyrogenic arthritis of the hip: operation giving free access and effective drainage. Lancet. 1943;1:419–21.
  6. Grauer JD, Amstutz HC, O’Carroll PF, Dorey FJ. Resection arthroplasty of the hip. J Bone Joint Surg Am. 1989;71(5):669–78.
  7. Zhigun AI. Consequences of acetabular fractures: prediction, diagnosis, treatment (clinical and experimental research): the dissertation of the doctor of medical sciences: 14.01.21. Kharkiv, 2010. 307 pр. (in Russian)
  8. Sahin V, Karakaş ES, Aksu S, Atlihan D, Turk CY, Halici M. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. J Trauma. 2003;54(3):520–9. doi: 10.1097/01.TA.0000020394.32496.52.
  9. Bruce WJ, Rizkallah SM, Kwon YM, Goldberg JA, Walsh WR. A new technique of subtrochanteric shortening in total hip arthroplasty: surgical technique and results of 9 cases. J Arthroplasty. 2000;15(5):617–26.
  10. Chareancholvanich K, Becker DA, Gustilo RB. Treatment of congenital dislocated hip by arthroplasty with femoral shortening. Clin Orthop. 1999;360:127–35.
  11. Sener N, Tozun IR, Asik M. Femoral shortening and cementless arthroplasty in high congenital dislocation of the hip. J Arthroplasty. 2002;17(1):41–8.
  12. Baumgart R, Krammer M, Winkler A, Hinterwimmer S, Muensterer O, Mutschler W Reduction of high dislocation of the hip using a distraction nail before arthroplasty. J Bone Joint Surg Br. 2005;87(4):565–7. doi: 10.1302/0301-620X.87B4.16080.
  13. Lai KA, Liu J, Liu TK. Use of iliofemoral distraction in reducing high congenital dislocation of the hip before total hip arthroplasty. J Arthroplasty. 1996;11:588–93.
  14. Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia: surgical technique. J Bone Joint Surg Am. 2010;92,1(2):176–87. doi: 10.2106/JBJS.J.00061.
  15. Starker M, Bischof F, Lindenfeld T. Total hip arthroplasty with shortening subtrochanteric osteotomy and custom-made prosthesis in Crowe type IV developmental dysplasia. Z Orthop Unfall. 2011;149(5):518–25. doi: 10.1055/s-0031-1280029.
  16. Akiyama H, Kawanabe K, Yamamoto K, Kuroda Y, So K, Goto K, Nakamura T.Cemented total hip arthroplasty with subtrochanteric femoral shortening transverse osteotomy for severely dislocated hips: outcome with a 3- to 10-year follow-up period. J Orthop Sci. 2011;16(3):270–77. doi: 10.1007/s00776-011-0049-z.
  17. Charity JA, Tsiridis E, Sheeraz A, Howell JR, Hubble MJ, Timperley AJ, Gie GA. Treatment of Crowe IV high hip dysplasia with total hip replacement using the Exeter stem and shortening derotational subtrochanteric osteotomy. J Bone Joint Surg Br. 2011;93(1):34–8. doi: 10.1302/0301-620X.93B1.24689.
  18. Symeonides PP, Pournaras J, Petsatodes G, Christoforides J, Hatzokos I, Pantazis E. Total hip arthroplasty in neglected congenital dislocation of the hip. Clin Orthop. 1997;341:55–61.
  19. Lund KH, Termansen NB. Hip replacement for congenital dislocation and dysplasia. Acta Orthop Scand. 1985;56:464–8.
  20. Crowe JF, Mani VJ, Ranawat CS. Total hip arthroplasty in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61:15–23.
  21. Oe K, Iida H, Nakamura T, Okamoto N, Wada T. Subtrochanteric shortening osteotomy combined with cemented total hip arthroplasty for Crowe group IV hips. Arch. Orthop. Trauma Surg. 2013;133(12):1763–70. doi: 10.1007/ s00402-013-1869-4.
  22. Minter JE, Bernasek TL, Malone MR, Schmitt P. Use of the AO femoral distractor in revision total hip arthroplasty. Am J Orthop. 2003;32(9):464–5.
  23. Eldridge JC, Bell DF. Problems with substantial limb lengthening. Orthop Clin North Am. 1991;22;625–31.
  24. Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop. 1990;250:81–104.
  25. D'Antonio JA, Capello WN, Borden LS, Bargar WL, Bierbaum BF, Boettcher WG, Steinberg ME, Stulberg SD, Wedge JH. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res. 1989;243:126–37.
  26. Harris W. H. Traumatic artritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg. 1969;51-A(4):737–55.
  27. De Lee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20–32.
  28. Gruen TA, McNeice GM, Amstutz HC. Modes of failure of cemented stem-type femoral components. Clin Orthop. 1979;141:17–27.
  29. Filipenko VА, Bondarenko SЕ, Zhigun АI. Method of cement fixation of acetabular component in total hip arthroplasty with osteoporosis. Patent 95232 UA, IPC A61F 2/34, A61F 2/36. No. u201408480. 10.12.2014; 10.12.2014; Bull. No. 16.

Downloads

How to Cite

Filipenko, V., Bondarenko, S., Khmyzov, S., Zhygun, A., & Panchenko, A. (2017). Joint replacement in patients with consequence of non-reduced hip joint fracture-dislocations. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 78–83. https://doi.org/10.15674/0030-59872017278-83

Issue

No. 2 (2017)

Section

ORIGINAL ARTICLES

License

Copyright (c) 2017 Volodymyr Filipenko, Stanislav Bondarenko, Sergey Khmyzov, Anatoliy Zhygun, Anastasia Panchenko

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).