Treatment of older children with Stage 3 secondary coxarthrosis associated with lower limb shortening above 6 cm by the technique of total replacement

Abstract

Purpose. To analyze the possibilities of using the technique of replacement in order to correct the hip deformity and recover the hip function in adolescents with secondary coxarthrosis for dysplasia, traumatic and infection involvement consequences associated with lower limb shortening above 6 cm.
Materials and Methods. The results of surgical treatment demonstrated in 10 patients at the age of 13-18 years with Stage 3 secondary coxarthrosis associated with great limb shortening. Two-staged technique of surgical treatment proposed which allows to restore the limb length and function. The technique is characterized by the hip single-stage intervention. Results. The results of surgery evaluated by the data of radiologic, anthropometric and clinical examination of 10 patients within the periods from 9 months to 3 years. All the components were stable by X-rays and clinically. There was no pain syndrome, nobody used additional supports. The signs of inflammation in the surgery area were absent in all the patients.
Conclusion. The proposed two-staged technique of total replacement in older children with secondary coxarthrosis associated with shortening above 6 cm allows to achieve the limb length discrepancy on the affected side. In this case the pain syndrome can eliminated completely, and the hip function and walking biomechanics restored to a large extent in most cases.