Ilizarov hip reconstruction - A narrative review

 Title: Ilizarov hip reconstruction - A narrative review

Authors: Mishra S, Yadav AK, Raj RK, Jha A, Ahuja D, Parihar M

Journal: The Kerala Journal of Orthopaedics

Year: 2019 Volume: 3 Issue: 2 Pages: 84-96

DOI: https://doi.org/10.4103/kjo.kjo_47_19

Publication Type: Review Article

Summary:

The Ilizarov technique has revolutionized the management of complex orthopedic problems including those involving the hip. In this narrative review, we discuss our experience with using the Ilizarov frame for hip reconstructions over two decades at our institution. We describe indications and contraindications, surgical techniques and the use of modern adjuncts such as external fixators, locking plates, and bone graft substitutes. We also highlight complications associated with this approach and offer suggestions to minimize them. Finally, we provide an update on recent advances in the field and conclude by emphasizing the importance of proper patient selection and meticulous execution of the procedure for optimal outcomes.

Take some Questions on this article:

1. What is the main aim of hip reconstruction osteotomy for patients with hip instability?

   • A) To achieve painless and stable hip joints1
   • B) To perform arthrodesis or total hip arthroplasty
   • C) To increase the range of motion and gait of the hip
   • D) To reduce the infection and neoplastic risk of the hip
   • Answer: A*

2. What is the name of the technique that Ilizarov modified to add a distal femoral varus osteotomy along with the proximal femur osteotomy?2

   • A) Hip arthroplasty
   • B) Pelvic support osteotomy3
   • C) Subtrochanteric valgus-extension osteotomy
   • D) Transosseous osteosynthesis4
   • Answer: B*

3. What is the most common complication of Ilizarov hip reconstruction?

   • A) Pin tract infections
   • B) Fractures of the regenerate
   • C) Premature consolidation
   • D) Residual limb-length discrepancy
   • Answer: A*

4. What is the name of the classification system used to assess the stage of hip instability?

   • A) Hunka classification
   • B) Bombelli classification
   • C) Catagni classification
   • D) Emara classification
   • Answer: A*

5. What is the name of the device that can be used to perform Ilizarov hip reconstruction?

   • A) Ilizarov fixator
   • B) Monolateral fixator
   • C) Both A and B
   • D) Neither A nor B
   • Answer: C*

6. What is the advantage of using a monolateral fixator over an Ilizarov fixator?

   • A) It allows indefinite adjustment and six-axis correction
   • B) It is more convenient and less operative time
   • C) It is more forgiving and has a shorter learning curve
   • D) It is more stable and less prone to infection
   • Answer: B*

7. What is the disadvantage of using a monolateral fixator over an Ilizarov fixator?

   • A) It requires meticulous planning and is unforgiving
   • B) It causes more pain and discomfort for the patient
   • C) It limits the range of motion and lengthening of the limb
   • D) It increases the risk of mechanical axis deviation and genu valgum
   • Answer: A*

8. What is the rate of distraction at the distal osteotomy site after Ilizarov hip reconstruction?

   • A) 0.5 mm per day, divided into two rounds
   • B) 1 mm per day, divided into four rounds
   • C) 1.5 mm per day, divided into six rounds
   • D) 2 mm per day, divided into eight rounds
   • Answer: B*

9. When is distraction started at the distal osteotomy site after Ilizarov hip reconstruction?

   • A) On the day of surgery
   • B) On three postoperative days
   • C) On seven postoperative days5
   • D) On ten postoperative days
   • Answer: C*

Ref: 1. Page 1 - Line 16, 2. Page 1 - Line 111, 3. Page 1 - Line 48, 4. Page 6 - Line 80, 5. Page 4 - Line 5, 6. Page 5 - Line 67, 7. Page 2 - Line 55