Subtrochanteric transverse shortening osteotomy in cementless total hip arthroplasty achieved using a modular stem

Abstract

It is challenging to reconstruct normal hip motion after a high hip dislocation. Although total hip arthroplasty (THA) with shortening osteotomy is a solution for high hip dislocation, osteotomy nonunion is a major complication. To improve the rate of osteotomy union, subtrochanteric transverse shortening osteotomy was performed using a modular-type stem, S-ROM, that can be fixed to both the proximal and distal parts of the femur individually with a stepped proximal sleeve and polished distal flutes with fins, respectively. The stem can facilitate union of the osteotomy by maintaining rigid rotational stability and generating compression pressure between bone parts of the femur even in simple transverse osteotomy. Moreover, transverse osteotomy is technically simple and minimizes the damage of the periosteum at the osteotomy. In our series, this procedure was performed on 6 hips in 6 patients with high hip dislocation. The mean follow-up period was 8.1 years. Osteotomy union was achieved in all patients for a mean of 8.8 weeks. This procedure is a good option for surgical treatment of high hip dislocation.