抄録
A 52-year-old woman had congenital dislocation of both hips and a waddling gait with occasional hip pain since childhood. At the age of 30, she underwent a Schanz osteotomy on the right hip and one year later, on the left. After surgery her gait improved, but she became unable to ride a bicycle or sit upright and after a few years her hip pain and gait worsened.
One year ago in our clinic her hip joints were replaced with a Bioceram type 5 prosthesis. At the same time a bone graft was performed for the hypoplastic acetabulum using a supporting metal ring. The proximal femur was widely removed and the greater trochanter was transplanted to the proximal femoral shaft distal to the original site after the femoral component was cemented. Postoperatively, the hip pain decreased, the range of motion of the joints increased and the Trendelenburg sign became negative.
The hip evaluation score according to the JOA criteria increased markedly after surgery, from 35 to 70 in the right hip, and from 40 to 70 in the left hip. Postoperative activity during daily training caused some intractable pain in her feet with hallux valgus deformities. This was successfully treated with a McBride operation.
Even for the markedly hypoplastic hip following a Schanz osteotomy, total hip replacement can be performed if the proper prosthesis is available.
