Orthop Surg. 2026 Apr 1. doi: 10.1111/os.70302. Online ahead of print.
ABSTRACT
OBJECTIVE: Subtrochanteric shortening osteotomy (SSO) with autogenous cortical plate grafting is a critical but technically demanding procedure in total hip arthroplasty for Crowe type IV developmental dysplasia of the hip. Conventional instruments often result in inaccurate osteotomies and unstable graft fixation. This study aimed to evaluate a novel surgical instrumentation system designed to address these challenges.
METHODS: A retrospective cohort study was conducted on 49 patients (60 hips) with Crowe type IV DDH who underwent primary THA with SSO. The control group included 25 patients (30 hips) treated with conventional instruments. The novel instrumentation group included 24 patients (30 hips) treated with the newly developed system. All surgeries were performed by a single senior surgeon. Demographic and clinical data were analyzed, and all patients completed the 24-month postoperative follow-up. Statistical analysis was performed using t-tests and chi-squared tests as appropriate.
RESULTS: The mean operative time was significantly shorter in the novel instrumentation group than in the control group (t = 2.123, p = 0.040). The novel instrumentation system was estimated to reduce the time required for the autogenous cortical plate technique by 43%. Patients in the novel instrumentation group also reported significantly less intraoperative blood loss (t = 3.078, p = 0.003). The satisfaction rate regarding autogenous graft and wire positions was significantly higher in the novel instrumentation group (χ2 = 5.455, p = 0.020). No significant differences were observed in clinical scores between the two groups during the 24-month follow-up. No severe perioperative or postoperative complications occurred in either group.
CONCLUSION: The novel surgical instrumentation system demonstrated advantages over conventional devices in terms of operating time, blood loss, and satisfaction with autogenous graft and wire positioning. It represents an ideal set of surgical tools for Crowe type IV DDH patients undergoing THA with SSO.
LEVEL OF EVIDENCE: Level III, retrospective study.
PMID:41919348 | DOI:10.1111/os.70302
