RESEARCH ARTICLE


Lower Limbs Alignment in Patients with a Unilateral Completely Dislocated Hip



Shinsuke Someya, Motoki Sonohata*, Shuya Ide, Satomi Nagamine, Tomonori Tajima, Masaaki Mawatari
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan


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© Someya et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

Correspondence: Address correspondence to this author at the Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan; Tel: +81-952-34-2343; Fax: +81-952-34-2059; E-mail: epc9719@yahoo.co.jp


Abstract

Background:

Severe hip osteoarthritis is known to lead to secondary osteoarthritis of the knee joint. It is not clear whether contracture or a leg length discrepancy is more important in determining the knee alignment.

Methods:

In this study, 48 hips in 48 patients with a unilateral completely dislocated hip (Crowe IV) were recruited. The patients were divided into two groups (Crowe IVa and IVb). The Crowe IVa group had completely dislocation with psudo-articulation, and the Crowe IVb group had completely dislocation without psudo-articulation. The lower limb alignment was divided into three patterns according to the femorotibial angle; varus (≥176 degrees), neutral(170 to 175 degrees) and valgus(≤169 degrees).

Results:

The combination of valgus alignment on the affected side and varus alignment on the unaffected side, so-called “windswept deformity” was observed in 12.5% of the patients; this included 18.2% and 7.7%, in the Crowe IVa and Crowe IVb groups, respectively. The valgus alignment on the unaffected side, namely “long leg arthropathy,” was found to have occurred in 6.3% of the patients, including 13.6% of the patients in the Crowe IVa group; there were no cases of long “leg arthropathy” in the Crowe IVb group.

Conclusion:

The lower limb alignment on the unaffected side had a tendency to be varus in the Crowe IV patients. The “windswept deformity” was observed in each of the groups; however, “long leg arthropathy” was only found in the Crowe IVa group.

Keywords: Completely dislocated hip, Contracture, Coxitis knee, Leg length discrepancy, Long leg arthropathy, Lower limb alignment, Windswept deformity.