Hip arthrodesis with the dynamic hip screw.

Abstract

The authors report a series of 10 patients (4 male, 6 female) with end-stage hip degeneration who underwent unilateral hip arthrodesis at an average age of 19 years (range 14-35). Surgery was performed with the patient in the supine position through a Watson-Jones approach and fixation was stabilized with the AO Dynamic Hip Screw (DHS). After surgery, patients were mobilized in a short hip spica. Stable fixation with the DHS could not be achieved at surgery in one patient. Bony union was achieved in seven of the nine patients (78%) with a DHS after an average of 17 weeks (range 9-34). In one patient a painful nonunion developed; it was converted to a total hip arthroplasty 23 months later. Another patient obtained a painless pseudarthrosis, for which no further surgery is planned. The DHS provides a satisfactory means of stabilizing a hip arthrodesis when combined with a hip spica. This method of arthrodesis does not violate the origin or insertion of the abductor mechanism, thereby facilitating future conversion to total hip arthroplasty.