Clinical and Radiological Results of Crowe Type 3 or 4 Dysplasia Patients Operated on With Total Hip Arthroplasty Using a Cementless Rectangular Femoral Component Without Fixating or Grafting the Transverse Osteotomy Site

The round femoral stem provides a similar clinical outcome but more serious proximal stress shielding compared to the rectangular stem in cementless total hip arthroplasty without a shortening osteotomy in patients with Crowe type 2 or 3 hip dysplasia

“…Excellent results from previous studies[ 6 , 12 , 13 ] cemented the use of SL-Plus® and Synergy® stems in dysplastic hips. [ 2 , 3 ] Although a previous study indicated that round and tapered stem had less favorable clinical results compared to cylindrical stem in Crowe type 4 hips undergoing a step-cut osteotomy,[ 14 ] the round stem was shown to yield excellent results in Crowe type 2 and 3 hips in another study. [ 3 ] The authors reported complication-free results with a minimum of 10 years follow-up implanting the Synergy® component in a patient cohort of Crowe type 2 and 3 hips.…”

“…Dysplastic femurs differ in most of the anatomic parameters compared to healthy controls, in particular, Crowe type 2 and 3 hips. [ 1 ] Although a shortening osteotomy is mostly indispensable for high riding hips,[ 2 ] a less severe displacement of femoral head as in Crowe type 2 or 3 may be addressed successfully with THA without a shortening osteotomy. [ 3 ] Dysplasia and superior migration of the femoral head make the surgical application of THA challenging in these patients.…”

“…Rectangular and round stems have been shown to provide successful long-term survival in THA both in primary coxarthrosis or dysplastic hips. [ 2 , 6 ] Rectangular implants bear the advantage of less intramedullary bone removal and early inherent implant stability with four-point rotational stability. [ 7 ] On the other hand, round, double tapered, and fluted stems were also shown to provide excellent clinical and radiological results,[ 3 ] although a former study documented high-grade stress shielding on long-term follow-up in a dysplastic coxarthrosis cohort.…”

“…Dysplastic femurs differ in most of the anatomic parameters compared to healthy controls, in particular, Crowe type 2 and 3 hips. [1] Although a shortening osteotomy is mostly indispensable for high riding hips, [2] a less severe displacement of femoral head as in Crowe type 2 or 3 may be addressed successfully with THA without a shortening osteotomy. [3] Dysplasia and superior migration of the femoral head makeObjectives: This study aims to compare clinical and radiological follow-up results of a rectangular (SL-Plus ® ) or a round (Synergy ® ) femoral component in patients with Crowe type 2 or 3 hip dysplasia operated with total hip arthroplasty (THA) without a shortening osteotomy.Patients and methods: Between January 2012 and December 2017, a total of 34 hips of 30 female patients (mean age: 42.9±11.6 years; range, 24 to 66 years) were retrospectively analyzed.…”

A Semi-automatic Diagnosis of Hip Dysplasia on X-Ray Films

“…Although three dimensional structure of hip joint can be derived from CT and MRI images, it has to be faced with relatively high fees of medical check and high radiation. Therefore, the radiograph of pelvis from a X-ray film becomes the main early diagnosis of hip dysplasia (Kayaalp et al, 2020;Powell et al, 2020). Inevitably, the ever-growing numbers of X-ray films increase the burden of radiologists.…”