Optimal Level for Subtrochanteric Femoral Shortening Osteotomy in Crowe Type 4 Patients

Objective: To investigate the optimal level for femoral shortening osteotomy in patients with dislocated hips undergoing total hip arthroplasty (THA) and make recommendations to avoid union problems.

Methods: We retrospectively reviewed 65 hips of 55 patients who underwent total hip arthroplasty for Crowe type IV developmental dysplasia of the hip. Osteotomy level is defined as the distance between the lesser trochanter and osteotomy line. The role of osteotomy level and osteotomy level-stem end distance on non-union rates, radiological union time, unsupported loading time, and Harris Hip Scores were investigated with Pearson correlation analyses.

Results: The mean follow-up period was 75.9 ± 32.0 months. The mean radiological union time was 6.5 ± 2.9 months. There was a positive and linear correlation between osteotomy level and radiological union time (r=0.385; P=.003). Harris Hip Scores were not correlated with osteotomy level (P=.503). The osteotomy performed at a distance of more than 30 mm had higher radiological union times (P=.002).

Conclusion: According to the results of the current study, the optimal osteotomy level should be within the 20-30 mm range from the lesser trochanter. Early revision should be avoided for patients with union problems. To prevent non-union, the cable should be well controlled so as not to enter into the osteotomy line.

Cite this article as: Alpay Y, Albayrak K, Ezici A, Kürk MB, Akbulut D, Gürsu S. Optimal level for subtrochanteric femoral shortening osteotomy in crowe type 4 patients. Arch Basic Clin Res., 2023;5(2):256-262.