Changes in hip, knee and ankle coronal alignments after total hip arthroplasty with transverse femoral shortening osteotomy for unilateral Crowe type IV developmental dysplasia of the hip

• Published in: The Journal of arthroplasty Vol. 32; no. 11; pp. 3449 - 3456
• Main Authors: Misir, Abdulhamit, MD, Kizkapan, Turan Bilge, MD, Yildiz, Kadir Ilker, MD, Kaygusuz, Mehmet Akif, Alpay, Yakup, MD, Ezici, Atakan, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017
• Subjects: Adult; Ankle Joint - physiology; Arthroplasty, Replacement, Hip; coronal plane alignment; Crowe type IV; Female; femoral shortening osteotomy; Femur - physiology; Femur - surgery; Hip Dislocation, Congenital - surgery; Hip Joint - physiology; Hip Joint - surgery; Humans; Knee Joint - physiology; lower extremity; Lower Extremity - physiology; Male; Middle Aged; Orthopedics; Osteotomy - methods; Postoperative Period; Radiography; Retrospective Studies; Tibia - physiology; total hip arthroplasty; Young Adult; femoral shortening osteotomy; total hip arthroplasty; Coronal plane alignment; lower extremity; Crowe type IV; coronal plane alignment
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2017.05.044

Abstract Aims To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. Patients and Methods We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle (HKA), anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle (mLPFA), anatomical medial proximal femoral angle (aMPFA), mechanical lateral distal femoral angle (mLDFA), anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle (AJOA), tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides. Results Postoperatively, there were significant changes in FO (p = 0.001), HKA (p = 0.004), MAD (p = 0.016), mLPFA (p = 0.001), aMPFA (p = 0.012), mLDFA (p = 0.043), and AJOA (p = 0.012) on the operative side. Only MAD (p = 0.035) changed significantly on the nonoperative side. Conclusion Modification of FO and reconstruction of hip joint anatomy led to neutralization of knee and ankle valgus alignment. Effects on the nonoperative side were minimal.