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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.