Treatment of severe sequelae of infantile hip sepsis with trochanteric arthroplasty

We retrospectively reviewed 30 hips in 30 patients with complete destruction of the femoral head and neck from infantile septic arthritis to investigate the result and the ideal age for performance of trochanteric arthroplasty. All patients were treated with a 1-stage trochanteric arthroplasty at age from 11 to 98 months. We measured the range of motion of the hip, and we used the modified Harris hip score to evaluate pain and hip function and the multiplier growth-remaining method to assess predicted limb-length discrepancy. At a mean 7-year follow-up, we found that the modified Harris hip scores were negatively correlative--and the predicted limb-length discrepancy positively correlative--with the age at surgery in months. Range of motion in flexion and abduction of the hips of patients operated on at age older than 4 years were worse than that of the hips of patients operated on at age younger than 4 years. Therefore, we recommend that trochanteric arthroplasty should be performed as early as age 1 year for children with Hunka type V deformities after infantile septic arthritis of hip. Children older than 4 years might be contraindicated for trochanteric arthroplasty.