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Surgical Techniques   |    
Evaluation of the Modified Albee Arthroplasty for Femoral Head Loss Secondary to Septic Arthritis in Young ChildrenSurgical Technique
Xue-dong Li, MD, PhD1; Bin Chen, MD1; Shao-wei Luo, MD1; Shi-jun Ji, MD2; Shi-xin Du, MD, PhD1
1 Department of Orthopaedics, the 1st Affiliated Hospital, Medical College of Shantou University, 57 Chang Ping Road, Shantou, Guangdong 515041, China. E-mail address for S.-x. Du: dsx126333@sina.com.cn
2 Department of Pediatric Orthopaedics, the Second Affiliated Hospital, China Medical University, 36 Shan Hao Road, Shenyang, Liaoning 110004, China
View Disclosures and Other Information
DISCLOSURE: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the 1st Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong, China
The original scientific article in which the surgical technique was presented was published in JBJS Vol. 92-A, pp. 1370-80, June 2010
The line drawings in this article are the work of David A. Rini (drini@jhmi.edu).

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2011 Mar 16;93(Supplement 1):54-61. doi: 10.2106/JBJS.J.01160
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Abstract

BACKGROUND: 

Surgical treatment options for femoral head deficiency in infants secondary to septic arthritis of the hip are varied and associated with uncertain long-term outcomes. The modified Albee arthroplasty has been considered an acceptable procedure; however, the long-term outcomes of this procedure have not been reported, to our knowledge. We evaluated the long-term outcomes of the modified Albee arthroplasty in young patients with severe sequelae of septic arthritis of the hip.

METHODS: 

We retrospectively studied twenty-one children (twenty-one hips) in whom Choi type-IVB sequelae of septic arthritis of the hip had been treated with a modified Albee arthroplasty and six patients with the same sequelae who had been managed with simple observation. The Trendelenburg sign, pain, the range of motion, hip function, the Harris hip score, and limb-length discrepancy were assessed clinically. Remodeling of the femoral head, hip stability, and arthritic changes in the hip were evaluated radiographically.

RESULTS: 

The twenty-one patients with the modified Albee arthroplasty were followed for an average of 121.2 ± 38.6 months and had better outcomes, in terms of the Trendelenburg sign, the Harris hip score, pain, the hip range of motion, and limb-length discrepancy, than the six patients who underwent simple observation. Patients who were two years of age or younger at the time of the arthroplasty exhibited a significantly less severe limb-length discrepancy and less loss of motion than those who were older than two at the time of the surgery. Furthermore, limb-length discrepancy was positively correlated and the range of motion of the hip and the Harris hip scores were negatively correlated with the patient's age at the time of the surgery, suggesting that early surgery in patients with severe sequelae of septic arthritis of the hip is associated with a better clinical outcome.

CONCLUSIONS: 

The modified Albee arthroplasty is a feasible and clinically useful procedure for the treatment of severe sequelae of septic arthritis of the hip, particularly in children who are two years of age or younger.

LEVEL OF EVIDENCE: 

Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION: 

"Evaluation of the Modified Albee Arthroplasty for Femoral Head Loss Secondary to Septic Arthritis in Young Children" (2010;92:1370-80)

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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