Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study
Abstract Introduction Total hip arthroplasty (THA) is a cornerstone intervention for Crowe Type 4 developmental dysplasia of the hip (DDH), a severe form characterized by complete hip dislocation and acetabular deficiency. This study aimed to evaluate the incidence of nerve injury in patients underg...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-025-09012-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849344276333330432 |
|---|---|
| author | Afshin Taheriazam Erfan Poursaleh Ahmad Abbaszadeh Mehdi Samberani Parsa Taheriazam Rezvan Darabi Salar Baghbani |
| author_facet | Afshin Taheriazam Erfan Poursaleh Ahmad Abbaszadeh Mehdi Samberani Parsa Taheriazam Rezvan Darabi Salar Baghbani |
| author_sort | Afshin Taheriazam |
| collection | DOAJ |
| description | Abstract Introduction Total hip arthroplasty (THA) is a cornerstone intervention for Crowe Type 4 developmental dysplasia of the hip (DDH), a severe form characterized by complete hip dislocation and acetabular deficiency. This study aimed to evaluate the incidence of nerve injury in patients undergoing THA via trochanteric osteotomy and proximal femoral shortening, with a secondary focus on the impact of prosthesis type (cemented vs. cementless). Material and method A prospective cohort study was conducted in Iran on 62 patients (81 hips) with Crowe Type 4 developmental dysplasia of the hip between 2020 and 2022. All procedures utilized a standardized direct lateral approach with trochanteric osteotomy and femoral shortening (3–4 cm). Nerve injury was assessed postoperatively via electromyography/nerve conduction velocity (EMG/NCV). Continuous variables were analyzed using independent t-tests, categorical variables with chi-square tests, and significance set at P < 0.05. Results In this study, ultimately, 46 patients (62 hips) completed the study according to the protocol. Among the participants, 54 cases (87.1%) were female and 8 cases (12.9%) were male. The mean age and BMI of patients were 40.35 years and 25.19 Kg/m2, respectively. Finally,59 cases (95.2%) were without any neurological deficit and 3 cases (4.8%) developed neurological problem during 12 months after surgery. The frequency of neurological deficit had a statistically significant correlation with the type of prosthesis (P = 0.01). Conclusion Trochanteric osteotomy with proximal femoral shortening achieves substantial leg lengthening in Crowe Type 4 developmental dysplasia of the hip, with minimal nerve injury risk. Cementless prostheses demonstrated superior neurological safety, advocating for their preferential use. |
| format | Article |
| id | doaj-art-a548b1495eca4d7ab6decdfa6c644317 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-a548b1495eca4d7ab6decdfa6c6443172025-08-20T03:42:41ZengBMCBMC Musculoskeletal Disorders1471-24742025-08-012611610.1186/s12891-025-09012-0Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort studyAfshin Taheriazam0Erfan Poursaleh1Ahmad Abbaszadeh2Mehdi Samberani3Parsa Taheriazam4Rezvan Darabi5Salar Baghbani6Department of Orthopedics, School of Medicine, Tehran Medical Sciences, Islamic Azad UniversityDepartment of Orthopedics, School of Medicine, Tehran Medical Sciences, Islamic Azad UniversityDepartment of Orthopedics, School of Medicine, Tehran Medical Sciences, Islamic Azad UniversityDepartment of Orthopedics, School of Medicine, Tehran Medical Sciences, Islamic Azad UniversitySchool of Medicine, Shahid Beheshti University of Medical ScienceDepartment of Orthopedics, School of Medicine, Tehran Medical Sciences, Islamic Azad UniversityDepartment of Orthopedics, School of Medicine, Tehran Medical Sciences, Islamic Azad UniversityAbstract Introduction Total hip arthroplasty (THA) is a cornerstone intervention for Crowe Type 4 developmental dysplasia of the hip (DDH), a severe form characterized by complete hip dislocation and acetabular deficiency. This study aimed to evaluate the incidence of nerve injury in patients undergoing THA via trochanteric osteotomy and proximal femoral shortening, with a secondary focus on the impact of prosthesis type (cemented vs. cementless). Material and method A prospective cohort study was conducted in Iran on 62 patients (81 hips) with Crowe Type 4 developmental dysplasia of the hip between 2020 and 2022. All procedures utilized a standardized direct lateral approach with trochanteric osteotomy and femoral shortening (3–4 cm). Nerve injury was assessed postoperatively via electromyography/nerve conduction velocity (EMG/NCV). Continuous variables were analyzed using independent t-tests, categorical variables with chi-square tests, and significance set at P < 0.05. Results In this study, ultimately, 46 patients (62 hips) completed the study according to the protocol. Among the participants, 54 cases (87.1%) were female and 8 cases (12.9%) were male. The mean age and BMI of patients were 40.35 years and 25.19 Kg/m2, respectively. Finally,59 cases (95.2%) were without any neurological deficit and 3 cases (4.8%) developed neurological problem during 12 months after surgery. The frequency of neurological deficit had a statistically significant correlation with the type of prosthesis (P = 0.01). Conclusion Trochanteric osteotomy with proximal femoral shortening achieves substantial leg lengthening in Crowe Type 4 developmental dysplasia of the hip, with minimal nerve injury risk. Cementless prostheses demonstrated superior neurological safety, advocating for their preferential use.https://doi.org/10.1186/s12891-025-09012-0Total hip arthroplasty (THA)Developmental dysplasia of the hip (DDH)Nerve palsyTrochanteric osteotomy |
| spellingShingle | Afshin Taheriazam Erfan Poursaleh Ahmad Abbaszadeh Mehdi Samberani Parsa Taheriazam Rezvan Darabi Salar Baghbani Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study BMC Musculoskeletal Disorders Total hip arthroplasty (THA) Developmental dysplasia of the hip (DDH) Nerve palsy Trochanteric osteotomy |
| title | Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study |
| title_full | Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study |
| title_fullStr | Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study |
| title_full_unstemmed | Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study |
| title_short | Nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in Crowe Type 4 developmental dysplasia of the hip: a prospective cohort study |
| title_sort | nerve palsy following total hip arthroplasty using trochanteric osteotomy and proximal femoral shortening in crowe type 4 developmental dysplasia of the hip a prospective cohort study |
| topic | Total hip arthroplasty (THA) Developmental dysplasia of the hip (DDH) Nerve palsy Trochanteric osteotomy |
| url | https://doi.org/10.1186/s12891-025-09012-0 |
| work_keys_str_mv | AT afshintaheriazam nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy AT erfanpoursaleh nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy AT ahmadabbaszadeh nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy AT mehdisamberani nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy AT parsataheriazam nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy AT rezvandarabi nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy AT salarbaghbani nervepalsyfollowingtotalhiparthroplastyusingtrochantericosteotomyandproximalfemoralshorteningincrowetype4developmentaldysplasiaofthehipaprospectivecohortstudy |