Abstract
The results of total hip arthroplasty (THR) combined with subtrochanteric collection osteotomy after proximal femoral osteotomy were investigated in 11 patients (13 affected hip joints) . The mean operation time was 208 minutes and the mean blood loss during surgery was 1700g.
The incidence of intraoperative complications was high, indicating the necessity of detailed preoperative treatment planning and careful operative techniques. Revision arthroplasty was required in some cases soon after surgery. To ensure initial fixation which determines short-term outcomes of this operation, it is essential to select a modular type stem which fits both the proximal bone pieces (interrupted medullary cavities) and the distal bone pieces. If the operation can be performed precisely, it should be possible to achieve stabilization of the osteotomized area. At present, we use S-ROM as the stem of first choice. This stem is selected with expectation of biological fixation of the proximal area. If biological fixation is unsure due to reduced blood supply to proximal bone pieces, the long-term outcome will be uncertain.
