Modular stem in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series

Abstract

Background: Trochanter valgus deformity (TVD) is a rare condition of total hip arthroplasty (THA). The femoral osteotomy might be required to correct the deformity to implant the femoral stem in severe TVD. In this study, we described one unpublished technique of reverse sleeve of S-ROM to get through the complex situation. This study aimed to summarize and evaluate its technical challenges, safety and effectiveness.Methods : From January 2006 to December 2014, the patients whose sleeves were implanted towards the great trochanter rather than sitting on the calcar, to solve the TVD in THA were enrolled. Their demographics, perioperative and postoperative information were recorded. To explore its indication, we measured and analyzed the ratio of greater trochanter/lesser trochanter (G/L ratio) and trochanter valgus angle (TVA).Results : Twelve patients (1 male and 11 female, average age 42.30±10.23) who had the complete clinical data were analyzed. The survivorship of femoral prosthesis were 100% with mean follow-up of 6 years. No other complications were found, except for two patients with intraoperative fracture of femur. The Harris hip score (HHS) increased from preoperative 34.31±14.43 to postoperative 84.12±11.33. All patients' G/L ratio were larger than 1.50.Conclusions: The reverse sleeve of S-ROM was a reliable method for the patients with severe trochanter valgus deformity, which brought satisfying clinical outcomes in mid-term follow-up.

Prótesis de revisión de cadera en paciente con secuelas de displasia del desarrollo de cadera. Reporte de un caso y revisión de la literatura

“…18 En lo que respecta al fémur, presenta un defecto proximal que se extiende a la diáfisis, el vástago indicado inicialmente no fue el correcto presentando hundimiento del mismo, ya que estos tipo de fémur presentan su anatomía irregular y son biomecánicamente insuficientes para una fijación metafisaria proximal, se decide retirar vástago realizando una osteotomía lateral femoral extendida, colocando un vástago modular cónico estriado, los cuales son los idóneos para este tipo defectos, ya que presentan una fijación diafisaria distal, donde al menos se requieren de 2 cm para que sean estables, otorgándoles estabilidad axial y rotacional. 19 Se colocan tablas de aloinjerto Figura 3: Subluxación de prótesis total de cadera. Foto del autor.…”