Total Hip Arthroplasty for High Hip Dislocation

Zeitschrift für Orthopädie und Unfallchirurgie
Sebastian HardtCarsten Perka

Abstract

Total hip arthroplasty in patients with high hip dislocation is a surgically demanding procedure. This is due to the congenital disorder of hip maturation and the resulting anatomical features. The aim of the arthroplasty is implantation of the cup prosthesis in the original centre of rotation, at the same time correcting femoral deformities and reducing the hip joint. The indications include advanced osteoarthritis in the secondary acetabulum, existing instability, severe contractures and secondary changes in adjacent joints. The contraindications include cerebrospinal dysfunction with impaired coordination, muscular dystrophies, overt metabolic bone disorders and complete or nearly complete absence of muscles that stabilise the hip/hip-stabilising musculature. The operation is preferably performed through an anterolateral approach with the patient supine or through a posterolateral approach with the patient on his side. Sparing the pelvitrochanteric muscles is crucial for the functional outcome. Exposure of the original acetabulum is essential for correct and secure placement of the cup component. We perform planned shortening femoral osteotomy above an increase in length of more than 3.0 cm in patients without previous surge...Continue Reading

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