Greater trochanteric preserving hip arthroplasty in the treatment of infantile septic arthritis: long-term results.

Abstract

Balanced forces around the hip joint are critical for normal development of the hip joint, so it should be considered in every hip reconstructive procedure. In seven children with complete destruction of the femoral head and neck due to septic arthritis, a reconstructive hip surgery was done to reconstruct the femoral head without sacrificing the greater trochanter and its muscles completely. The technique consists of a modified greater trochanter arthroplasty with only a medial portion of the greater trochanter and a varus femoral osteotomy. The average age of the children at surgery was 17 months (range 8-36 months) and the patients were followed for an average of 16.6 years (range 10.9-20.1 years). The average number of second operative procedures for each patient was 2 (range 1-4). The follow-up evaluation for each patient included documentation of pain, hip range of motion, and assessment of gait. In addition, the current leg-length discrepancy, final coverage and stability of the hip joint were documented. At final evaluation, all patients had a pain-free stable hip and two patients had near-normal hip range of motion. All patients have had satisfactory surgery results. By this kind of hip reconstruction, we could provide a stable painless hip joint with special attention to the greater trochanter's role on hip biomechanics.