scholarly journals Leg length measures appear inaccurate in the early phase following total hip arthroplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maria Anna Smolle ◽  
Stefan Franz Fischerauer ◽  
Michael Maier ◽  
Patrick Reinbacher ◽  
Jörg Friesenbichler ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Sacroiliac Joint ◽  
Iliac Crest ◽  
Weight Bearing ◽  
Harris Hip Score ◽  
Anatomical Landmarks ◽  
Leg Length ◽  
Leg Extension ◽  
Total Hip

AbstractThe aims of this study were to (1) assess reliability of leg length discrepancy (LLD) measurements at different anatomical landmarks, (2) longitudinally investigate LLD in patients within the first year following total hip arthroplasty (THA) and to (3) correlate changes in LLD with functional outcome. Ninety-nine patients with short stem THA (53.3% males, mean age: 61.0 ± 8.1 years) were prospectively included. Upright pelvic anteroposterior (a.p.) radiographs taken at 6 timepoints (preoperatively, discharge, 6, 12, 24, 52 weeks postoperatively) were used to assess LLD at 5 anatomical landmarks (iliac crest, upper sacroiliac joint, lower sacroiliac joint, tear drop figure, greater trochanter). WOMAC and Harris Hip Score (HHS) were obtained preoperatively and at 6 and 52 weeks. LLD measures significantly increased in the initial phase following THA, from discharge to 6 weeks postoperatively and remained constant thereafter. Documentation of LLDs is dependent on measurement site: LLDs varied significantly between trochanter and iliac crest to tear drop figure (p < 0.001). Functional assessments did not correlate with the occurrence of LLDs [WOMAC (p = 0.252); HHS (p = 0.798)]. Radiographic assessment of LLD following THA may not be performed early postoperatively, as measurements appear to inaccurately reflect actual LLDs at this time, potentially due incomplete leg extension and/or inhibited weight-bearing.

scholarly journals Greater increase in femoral offset with use of collum femoris-preserving stem than Tri-Lock stem in primary total hip arthroplasty

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092599
Author(s):  
Mengxuan Yao ◽  
Yuchuan Wang ◽  
Congcong Wei ◽  
Yongtai Han ◽  
Huijie Li
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Leg Length ◽  
Femoral Offset ◽  
Unaffected Side ◽  
Neck Shaft Angle ◽  
Total Hip ◽  
Stem Group

Objective This study was performed to compare the clinical outcomes and performance of the collum femoris-preserving (CFP) stem (Waldemar Link GmbH & Co., Hamburg, Germany) and the Tri-Lock stem (DePuy Orthopaedics, Warsaw, IN, USA) in terms of femoral offset (FO) and leg length reconstruction. Methods Clinical and radiographic data of patients who underwent total hip arthroplasty with either a CFP stem or Tri-Lock stem from January 2016 to March 2017 were compared (65 and 57 patients, respectively). The Harris hip score and Western Ontario and McMaster Universities Osteoarthritis Index were recorded. The FO, femoral vertical offset, and neck–shaft angle were measured at the last follow-up. The occurrence of dislocation and periprosthetic fracture during the follow-up period was recorded. Results The CFP stem induced significantly more FO than did the Tri-Lock stem on the operated side than contralateral side (3.63 ± 4.28 vs. 0.83 ± 5.46 mm). Significantly fewer patients had a >5-mm decrease in FO on the unaffected side in the CFP stem group ( n = 1) than Tri-Lock stem group ( n = 10). Conclusion Both stems similarly improved hip function and reconstructed the leg length, but the CFP stem was superior to the Tri-Lock stem in reconstructing FO.

scholarly journals Total hip arthroplasty for destructive septic arthritis of the hip using a two-stage protocol without spacer placement

2021 ◽  
Author(s):  
Christian Hipfl ◽  
Daniel Karczewski ◽  
Jakub Oronowicz ◽  
Matthias Pumberger ◽  
Carsten Perka ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Septic Arthritis ◽  
Hip Arthroplasty ◽  
Acute Infection ◽  
Treatment Success ◽  
Harris Hip Score ◽  
Leg Length ◽  
Two Stage ◽  
Total Hip ◽  
Aseptic Revision

Abstract Introduction The optimal treatment of patients with a degenerative joint disease secondary to an active or chronic septic arthritis of the hip is unclear. The aim of the present study was to report on our experience with two-stage total hip arthroplasty (THA) using a contemporary treatment protocol without spacer insertion. Materials and methods Our prospective institutional database was used to identify all patients with degenerative septic arthritis treated with a non-spacer two-stage protocol between 2011 and 2017. Clinical outcomes included interim revision, periprosthetic infection (PJI) and aseptic revision rates. Restoration of leg-length and offset were assessed radiographically. Modified Harris hip score (mHHS) were obtained. Treatment success was defined using the modified Delphi consensus criteria. Mean follow-up was 62 months (13–110). Results A total of 33 patients with a mean age of 60 years (13–85) were included. 55% of the cohort was male and average Charlson Comorbidity Index (CCI) was 3.7 (0–12). 21 patients (64%) had an active/acute infection and 12 patients (36%) were treated for chronic/quiescent septic arthritis. Overall, 11 patients (33%) had treatment failure, including 5 patients who failed to undergo THA, 2 interim re-debridement for persistent infection, and 4 patients who developed PJI after an average of 7 months (0.3–13) following THA. The most common identified pathogen was Staphylococcus aureus (42.4%). No aseptic revision was recorded following THA. Leg-length and offset were successfully restored. Mean mHHS improved from 35.2 points to 73.4 points. Conclusion Two-stage THA without spacer placement is a viable treatment option for destructive septic arthritis of the hip, demonstrating comparable rates of infection control and functional outcome. However, definitive resection arthroplasty is not uncommon in these often critically ill patients.

scholarly journals AMIS Total Hip Arthroplasty using traction table: 5 years follow-up

10.29007/zddn ◽  
2019 ◽  
Author(s):  
Thomas Apostolou ◽  
Ioanna Chatziprodromidou
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Weight Bearing ◽  
Minimal Invasive ◽  
Harris Hip Score ◽  
Total Hip ◽  
The Mean

Minimal invasive surgery has gained popularity among hip surgeons and patients. Based on early studies, the method is described as a very promising alternative, with low dislocation rates, resulting in a non-traumatic procedure and early functional return. However, complication rates arising of the recent studies raise concern about the applied technique. The aim of the study is to present the clinical results and intra- and post-operative complications of the AMIS procedure in patients with osteoarthritis of the hip, managed with total hip arthroplasty with positioning table, in a 5 years follow up. One senior hip arthroplasty surgeon performed all surgeries. Three hundred eighteen consecutive patients (195 females, 123 males) were clinically and radiologically evaluated, postoperatively 2, 6 and 12 months. Mean patient age was 69.7 years (24 to 88). There was significant improvement according to Harris-Hip Score, ODI, SF-36 scales. The mean incision length was 7.5cm (6 to 8cm). The mean operating time was calculated at 85 minutes. The patients were discharged on the second post-operative day, able to walk with partial weight bearing. One month post-operative, the patients were advised for full weight bearing walking without crutches. Intraoperative complications included two femoral perforations. Postoperative complications included two patients with femoral fractures; one with dislocation; two with superficial infections; three with wound complications; three with femoral stem aseptic loosening; one with ceramic inner fracture and two acetabular component protrusion in the same patient, among which only the last patient had reoperation in both hips. Anterior Minimal Invasive Surgery of the hip is a non-traumatic procedure, associated with reduced pain, faster recovery and no major complications, but requires higher experience level from the hip surgeon.

scholarly journals Mid-term results of total hip arthroplasty with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing-Yao Jin ◽  
Taek-Rim Yoon ◽  
Kyung-Soon Park ◽  
Sheng-Yu Jin ◽  
Dong-Min Jung ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Trochanteric Osteotomy ◽  
Leg Length ◽  
Total Hip ◽  
Type Iv ◽  
The Mean ◽  
Dysplasia Of The Hip

Abstract Background This study aimed to explore mid-term clinical results of cementless total hip arthroplasty (THA) with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip (DDH). Methods Thirteen patients (13 hips) with Crowe type IV DDH who underwent THA with modified trochanteric osteotomy between May 2013 and October 2015 were retrospectively analyzed. The mean follow-up duration was 5.2 years (range, 4.9–6.1 years). Results The mean Harris Hip Score (HHS) significantly (p < 0.05) improved from 30.7 (range, 22–38) to 87.5 (range, 83–93). The mean leg length discrepancy (LLD) was 53.4 mm (range, 42.1–68.5 mm) preoperatively. The final LLD was 5.6 mm (range, 2.4–9.1 mm; p < 0.05). The mean leg length after surgery was 47.4 mm (range, 33.6–67.2 mm) and the femur shortening distance was 43.8 mm (range, 31.2–53.4 mm). The average duration of bone union for the greater trochanter (GT) was 2.5 months (range, 1.5–3.6 months). There was no infection, GT non-union, or loosening (septic or aseptic) of the stem or cup in any case. Conclusions THA with modified trochanteric osteotomy with a cementless cup is an effective treatment for Crowe type IV DDH. It can rebuild complex biomechanics and biology of hip dysplasia without increasing complications.

scholarly journals Conversion total hip arthroplasty with a proximally modular, distal fixation reconstruction prosthesis following cephalomedullar nail failure

2020 ◽  
Vol 30 (1_suppl) ◽  
pp. 26-33 ◽  
Author(s):  
Daniel Godoy-Monzon ◽  
Fernando Diaz Dilernia ◽  
Francisco Piccaluga ◽  
Alberto Cid Casteulani ◽  
Luis Turus ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Success ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Secondary Outcome ◽  
Consecutive Series ◽  
Leg Length ◽  
Total Hip

Background: The goals of intertrochanteric hip fracture (IHF) treatment are stable fixation, early mobilisation and function restoration. If the attempt to reduce, stabilise and fracture healing utilising a femoral cephalomedullar nail (CMN) fails, options for subsequent attempts are limited. Purpose: Evaluate the clinical and radiographic outcomes of conversion total hip arthroplasty (THA) using a modular stem following a CMN failure. Materials and methods: We retrospectively reviewed a consecutive series of patients with an IHF between 2012 and 2014 to identify CMN patients that went on to the subsequent failure and conversion to THA utilising a modular femoral stem (MFS). In all cases, MP Reconstruction Prosthesis (Waldemar Link, Hamburg, Germany) was implanted. Primary clinical outcomes were assessed using Harris Hip Score (HSS) before conversion procedure, 3 months, 6 months and recent office visit post-conversion THA thereafter. The secondary outcome was to analyse intra and postoperative complications. Serial radiographs at each follow-up interval were assessed for clinical success or to confirm adverse events. Results: 28 patients were included in the study; 17 were females. The average age was 72.7 years (SD ± 10.5); the average time from the index procedure to conversion THA was 12.6 months (SD ± 3.5). At baseline, average HHS was 42.1 (SD ± 3.6), improved to 80.7 (SD ± 5.1) at 3 months, 86.0 (SD ± 3.9) at 6-months which levelled off to 86.1 (SD ± 4.0) at final follow-up. There were 4 (14%) post-conversion complications: 2 dislocations, 1 superficial wound infection, 1 patient with symptomatic abductor deficiency. All 4 cases were conservatively treated successfully, the implants were retained, and the patients progressed without further issue. Conclusions: MFSs allow to successfully treat failed CMN and adverse variations in femoral anatomy with a device that will permit simultaneous correction of leg length, offset and version to relieve pain, restore function and create a durable prosthetic to host composite.

scholarly journals Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Atul F. Kamath ◽  
Okechukwu Anakwenze ◽  
Gwo-Chin Lee ◽  
Charles L. Nelson
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Bone ◽  
Leg Length ◽  
Total Hip ◽  
Antibiotic Spacer ◽  
Segmental Bone ◽  
Final Followup

Introduction. Total hip arthroplasty (THA) infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail.Methods. Three patients with infected THA with severe proximal femoral bone loss (Mallory type IIIB or greater) were treated using a custom antibiotic spacer. Clinical outcomes and any complications were recorded. Average followup was 49 months from final reimplantation.Results. Mean age at spacer placement (stage 1) was 53 years. The mean Harris Hip Score at final followup was 80. Two patients had asymptomatic heterotopic ossification, and one patient had a 2 cm leg-length discrepancy.Conclusions. A custom intramedullary nail antibiotic spacer is a reliable option in the staged management of the infected THA with severe proximal femoral bone loss. Benefits of this technique include limb salvage with maintenance of leg length, soft tissue tension, and functional status.

Retrospective Clinical and Radiological Outcomes of Total Hip Arthroplasty in 51 Patients After a Mean 8.2 Years Using the Nanos® Short-stem Prosthesis

2021 ◽  
Vol 39 ◽  
Author(s):  
Christian Fischer ◽  
◽  
Julia Dietz ◽  
Karl-Stefan Delank ◽  
Alexander Zeh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Survival Rates ◽  
Short Stem ◽  
Harris Hip Score ◽  
Leg Length ◽  
Total Hip ◽  
The Mean

Introduction: Over the past several years, femoral short-stem hip implants have become more popular as a treatment option in the field of primary hip arthroplasty for younger and more active patients. Current data on clinical outcomes and the implant survival rates in patients with short-stem implants cover a maximum of five to six years. The aim of this study was to assess the survival rates, as well as clinical and functional outcomes, in total hip arthroplasty (THA) using the Nanos® short-stem implant (Smith & Nephew, Marl, Germany) over a follow-up period exceeding 5 y. Materials and Methods: This single-center retrospective study included the first 100 patients who were treated at the Department of Orthopedics at the University Hospital Halle (Saale) between January 2008 and February 2009. Ultimately, the complete data of 51 patients (54 hips) were reviewed. The follow-up period was from May to November 2017. We evaluated patient satisfaction regarding pain and function using a grading system. The Harris Hip Score and Forgotten Joint Score were obtained to evaluate functional outcome after THA. Postoperative radiographic evaluation included the measurement of leg-length discrepancy, changes in the shaft axis, femoral offset and horizontal or vertical center of rotation. Potential postoperative shaft angulation or axial shaft migration was also determined. Radiographic images were checked for radiolucent lines and heterotopic ossification using the classification systems outlined by Green and Brooker. Results: The average follow-up was 97.8 months (8.2 y). The mean patient age at follow-up was 68 y and the body mass index was 28.2 kg/m2. The mean Harris hip score at follow-up was 92.0 and the Forgotten Joint Score was 91.7 %. Survey results showed that patient satisfaction and pain perception were rated very good. No significant change in leg length was observed (mean: 0.1 mm shortening). Overall, a rather varus stem positioning was detected postoperatively (mean: 3.1°). The femoral offset was slightly reduced on average in the entire patient group (mean: -1.8 mm). In the horizontal plane, lateralization of the center of rotation was detected overall (mean: 0.7 mm). In the vertical plane, cranialization was noted (mean: 1.4 mm). The CCD angle did not change. There was no further stem migration postoperatively. Radiolucent lines occurred in 10 cases in Gruen zones 1 and 7. Heterotopic ossification occurred in stages 1 to 3 according to the Brooker classification system. We found no cases of aseptic loosening or other reasons for revision. Conclusion: The outcomes after a mean follow-up of 97.8 months (8.2 y) showed that high levels of patient satisfaction and functional outcome can be achieved with the use of a short-stem endoprosthesis. Sufficient restoration of the patient's individual anatomy paired with high survival rates makes this short-stem prosthesis a reliable implant in total hip arthroplasty.

scholarly journals Total Hip Arthroplasty Through the Direct Anterior Approach With and Without the Use of a Traction Table; a Matched-control, Retrospective, Single Surgeon Study

2020 ◽  
Author(s):  
DIANE WERNLY ◽  
Julien Wegrzyn ◽  
Geoffroi Lallemand ◽  
Jaad Mahlouly ◽  
Christophe Tissot ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Leg Length ◽  
Total Hip ◽  
Operative Complications ◽  
Post Operative Complications

Abstract BackgroundHip surgeons performing total hip arthroplasty (THA) through the direct anterior approach (DAA) commonly use a traction table to facilitate exposure. Even though performing THA through DAA without traction table could be technically more demanding, this technique offers the advantage of intraoperative leg length comparison. Therefore, this study aimed to compare clinical outcomes, complication rates, component positioning and leg length discrepancy (LLD) after THA through the DAA performed with or without a traction table.MethodsA single-surgeon continuous series of 75 patients who underwent DAA THA performed with a traction table were matched for gender, age and BMI with 75 patients who underwent DAA THA performed without a traction table (male:62, female:88, with an average age of 68 y.o). Clinical and radiological outcomes, intra- and post-operative complications and LLD were retrospectively assessed.ResultsNo statistically significant difference was detected in surgical time, hospital stay, Harris Hip Score (HHS), complication rates, and implant positioning between the two groups. Leg length restoration was significantly more accurate in the group performed without a traction table (2.4 ± 2 mm vs. 3.7 ± 3.1 mm, respectively; p value ≤ 0.05). No LLD > 10 mm was reported in the group performed without traction table, whereas two cases (2.7 %) were reported in those performed with traction table.ConclusionPerforming THA through DAA without a traction table was associated with a significantly more accurate leg length restoration without significantly increase in the rates of intra- and post-operative complications.

scholarly journals SKOR FUNGSIONAL HIP (HARRIS HIP SCORE) PADA PASIEN OSTEOARTHRITIS (OA) HIP JOINT DENGAN DEFEK ACETABULUM YANG DILAKUKAN TOTAL HIP ARTHROPLASTY (THR) DAN ACETABULOPLASTY

Biomedika ◽  
2018 ◽  
Vol 10 (2) ◽  
Author(s):  
S Bawono ◽  
I Maryanto ◽  
M Idulhaq
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Weight Bearing ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Total Hip ◽  
Function Range

ABSTRAKTotal hip arthroplasty (THA) merupakan pilihan bagi hampir semua pasien dengan kelainan sendi panggul yang menyebabkan ketidaknyamanan dan gangguan fungsi. Hasil jangka panjang yang baik dikarenakan perangkat endoprosthetic tersebut mampu memberikan kemampuan menahan beban, mempertahankan fungsi, rentang gerak dan stabilitas. Peneliti  mencoba untuk mengevaluasi skor hip fungsional pasien osteoarthritis pinggul dengan defek pada acetabulum yang dilakukan tindakan THA dengan acetabuloplasty di Rumah Sakit Ortopedi X, Surakarta, sejak Januari - September 2016. Kemudian kami evaluasi untuk fungsional hip pasien sebelum dan sesudah operasi menggunakan Harris Hip Skor (HHS). Berdasarkan data yang diperoleh didapat jumlah sampel perempuan 18 pasien dan laki-laki 14 pasien. Pada karekter umur rentang umur sampel antara 49 tahun sampai 66 tahun. Penilaian skor HHS sebelum operasi memiliki rentang nilai 20,8 sampai dengan 69,4. Hasil pengukuran skor HHS terhadap sampel yang dilakukan setelah tindakan operasi adalah sebagai berikut Fair 9 pasien, Good 13 pasien, dan Excellent 10 pasien. Hasil penelitian dapat disimpulkan bahwa THA dan Acetabuloplasty memberikan hasil terapi terbaik pada pasien Osteoarthritis dengan defek acetabulum, meliputi kemampuan menahan beban tubuh, fungsi , rentang gerak dan stabilitas sendi.Kata Kunci: Osteoartritis Hip, Defek Acetabulum, THA, Total Hip Artroplasty, Acetabuloplasty, Harris Hip Score ABSTRACTTotal hip arthroplasty (THA) is an option for almost all patients with hip joint abnormalities that cause discomfort and disruption of significant function. This is because of good long-term results that the endoprosthetic device gives regarding the ability of weight-bearing, function, range of motion and stability of hip joint. We try to evaluate the functional hip score  of  hip  osteoarthritis patients with defects in the acetabulum, performed THA with acetabuloplasty in X Orthopaedic Hospital since January until September 2016. Then we evaluated for patient’s functional outcome before and after operation using Harris Hip Score (HHS). From 32 patients were reviewed and identified, there were 18 females and  14 males,  mean age was 57,5 y.o (range 49-66 y.o). All had primary THA and Acetabuloplasty. There were  10 patients have excellent functional outcome(90-100 based on Harris Hip Score/HHS),  13 patients have good functional outcome (80-0), 9 patients  have fair functional outcome (70 – 79),  no patient have poor functional outcome (60 – 69) and have failed functional outcome (below 60). In this study we concluded that THA and acetabuloplasty  gives  best treatment for osteoarthritis patient with acetabular defects , regarding the ability of weight-bearing, function, range of motion and stability of hip joint. Keyword : Osteoartritis Hip, Acetabular Defect, THA, Total Hip Arthroplasty,Acetabuloplasty, Harris Hip’s Score

scholarly journals Mid-term results of total hip arthroplasty with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip

2020 ◽  
Author(s):  
Jing Yao Jin ◽  
Taek Rim Yoon ◽  
Kyung Soon Park ◽  
Sheng Yu Jin ◽  
Yue Ju Liu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Trochanteric Osteotomy ◽  
Leg Length ◽  
Total Hip ◽  
Type Iv ◽  
The Mean ◽  
Dysplasia Of The Hip

Abstract Introduction: The objective of this study was to explore mid-term clinical results of cementless total hip arthroplasty (THA) with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip (DDH).Patients and method: Thirteen patients (13 hips) with Crowe type IV DDH who underwent THA used modified trochanteric osteotomy between May 2013 and October 2019 were retrospectively analyzed. Mean follow-up was 5.2 ± 0.8 years (range, 4.9-6.1 years).Results: Mean Harris Hip Score (HHS) significantly (p < 0.05) improved from 30.7 ± 5.8 (range, 22-38) to 87.5 ± 3.6 (range, 83-93). The mean leg length discrepancy (LLD) was 53.4 ± 9.1 mm (range, 42.1-68.5 mm) preoperatively. The final LLD was 5.6 ± 2.4 mm (range, 2.4-9.1 mm). The mean leg length after surgery was 47.4 ± 10 mm (range, 33.6-67.2 mm). The average duration of bone union for greater trochanter (GT) was 2.5 ± 0.6 months (range, 1.5-3.6 months). There was no infection, GT non-union, or loosening (septic or aseptic) of the stem or cup in any case.Conclusions: THA with modified trochanteric osteotomy with cementless cup is an effective treatment for Crowe type IV developmental dysplasia of the hip. It can rebuild complex biomechanics and biology of hip dysplasia without increasing complications.

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