Muscle and physical functions after one-stage total hip arthroplasty with shortening subtrochanteric osteotomy in an old-old patient with bilateral Crowe IV developmental dysplasia dislocated into the gluteal muscles: a case report

Introduction and importance: Although developmental dysplasia of the hip (DDH) patients aged over 80 years are occasionally encountered in Japan, most of them have severe deformity with complete dislocation and have not received any treatment in childhood. Therefore, surgical treatment for such patients remains extremely challenging, and few detailed reports have described postoperative muscle recovery and rehabilitation outcomes in this age group. Case presentation: The patient was a woman in her 80s who had bilateral Crowe IV DDH dislocated into the gluteal muscles without a history of DDH treatment. She experienced walking difficulties due to aging and had elements of sarcopenia. One-stage bilateral total hip arthroplasty (THA) with shortening of the subtrochanteric osteotomy was performed. Clinical discussion: The gluteal and knee extensor muscles in THA with shortening subtrochanteric osteotomy for Crowe IV dysplasia in old-old patients differ from those in conventional long-term outcomes; consequently, physical and gait performance did not reach the cutoff values for fall risk at several points. Conclusion: Long-term intervention that considers multidisciplinary aspects is necessary for postoperative rehabilitation for one-stage bilateral THA with shortening subtrochanteric osteotomy in old-old patients with sarcopenia.