بررسی نتایج دراز مدت آرتروپلاستی تروکانتر بزرگ در بیماران مبتلا به عفونت چرکی قبلی مفصل ران

Septic hip arthritis can result in several complications such as complete distruction of femural head and neck. For treatment of this problem greater trochanteric arthroplasty has been advised. In this study, long-term results of this treatment were assessed to identify its advantages and disadvantages. 15 patients with sequel of hip septic arthritis were operated at Shafa Rehabilitation Center from 1985 to 1991. 5 patients did not participate in follow-up study and were excluded. Out of 10 patients, 6 were females and 4 males with mean age of 3.5 years(2-10 years) at the time of surgery. 8 patients were operated with Wissman and 2 with Regult procedure, and were followed for 10-16 years(mean 12.4 years). All hips were at stage 4(2 were at 4A and 8 were at 4B). In 4 patients right hip and in 6 ones left hip was involved. Surgery was done in 6 patients with transfer of greater trochanter to acetabulum with proximal femur varus osteotomy only, and in 4 patients beside this surgery, peivic osteotomy was also done. After at least 10 years, 7 patients had no or little pain and they only had moderated or severe pain. Mean hip flexion was 83˚, internal rotation 15˚, external rotation 10˚ and abduction 25˚. 8 patients were suffering from limping. Shortening was 10-20mm in 3 patients and more than 20mm(mean 39mm) in 7 patients. In 6 patients affected hip was completely stable and in 4 was dislocated. Trendelenburg sign was positive in 7 and DJD was found in 4 patients. 9 patients were able to do their daily work and they were satisfied with their surgery. According to Hunka criteria the results were satisfactory in 4 and unsatisfactory in 6 patients.