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| Application of single plane-guided osteotomy with double Kirschner needle in rigid and ankylosis hip arthroplasty |
| WANG Changfeng, YANG Le, LI Liang, SHEN Guangyin |
| Department of Joint Surgery, Jiangsu Provincial Corps Hospital of Chinese People’s Armed Police Force, Yangzhou 225003, China |
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Abstract Objective To evaluate the accuracy and safety of single plane-guided osteotomy with double Kirschner needle in rigid and ankylosis hip arthroplasty. Methods From January 2008 to June 2022, total hip arthroplasty was used in the treatment of ankylosing spondylitis (AS) in 12 cases (24 hips) with hip rigidity and 23 cases (36 hips) with hip rigidity in Jiangsu Provincal Corps Hospital of Chinese People’s Armed Police Force. The posterolateral approach was performed. During the first osteotomy of the femoral neck, two 2.5 mm Kirschner needles were inserted into the femoral neck, lateral to the greater trochanter, 1.5~ 2.0 cm above the lesser trochanter, and the angle of the plane of Kirschner needles parallel to the acetabulum was adjusted by fluoroscopy to avoid damage to the anterior wall of the acetabulum. The first osteotomy was completed by cutting the neck of the femur along the lower edge of the Kirschner needle without affecting the work of the swinging saw. Hip ankylosis and stiffness were divided into two subgroups according to the boundary of ESR value of 30 mm/h. Hip flexion angle, adduction and abduction angle, residual hip flexion deformity and Harris function score before and after surgery were analyzed. The postoperative hip flexion angle, adduction and abduction angle, residual hip flexion deformity and Harris function score before and after surgery were analyzed. Results Intraoperative precise osteotomy was completed without anterior and posterior wall injuries of acetabulum. All patients were followed up for an average of 63.8 months (range, 50-86 months). The postoperative Harris score was higher than that before surgery (P<0.05), and the range of hip motion was improved (P<0.05). There were 6 cases of heterotopic ossification, including 4 cases of BrookerⅠand 2 caes of BrookerII which were asymptomatic and untreated. At the last follow-up, there was no loosening of the acetabular cup. Conclusions Single plane-guided osteotomy with double Kirschner needle is an effective method for ankylosis and rigid hip arthroplasty, which is simple to operate and can avoid the injuries of the anterior wall of the acetabulum and the complications related to the osteotomy of the greater trochanter.
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Received: 04 April 2023
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2023, Vol. 34 
