Intermediate follow-up of a simple method of hip arthrodesis in adolescent patients

Thierry E. Benaroch, B. Stephens Richards, Nessie Haideri, Cindy Smith

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Thirteen male patients (average age, 15.6 years) underwent intraarticular hip arthrodesis for unilateral disabling hip disease. Follow-up averaged 6.6 years. Seven patients had excellent or good Harris hip scares. Ten patients had low back pain, and seven patterns hail knee pain on the side of the fused hip. Limb-length discrepancy averaged 3.7 cm. A progressive hip adduction drift (average, 7°) occurred during follow-up. Patients whose hips were fused in a position of 20-25° flexion and whose limb-length discrepancies were <2 cm had significantly lower incidences of back pain. Cybex muscle testing revealed significantly decreased quadriceps strength (29%) on the hip-fusion side. Gait laboratory analysis demonstrated decreased velocity, stride length, and cadence. There were two mildly symptomatic nonunions. Based on these results, we recommend that the hip fusion be positioned in 20° flexion and 0° abduction. The joint must be completely debrided down to viable bone to maximize chances for union. Maintaining a limb-length discrepancy of <2 cm is essential to minimize the incidence of low back pain, quadriceps deficiency, and abnormal gait parameters.

Original languageEnglish (US)
Pages (from-to)30-36
Number of pages7
JournalJournal of Pediatric Orthopaedics
Volume16
Issue number1
DOIs
StatePublished - Jan 12 1996

Keywords

  • Back pain
  • Gait
  • Hip arthrodesis
  • Limb-length discrepancy
  • Quadriceps strength

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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