Arthrodiastasis in the management of stiff hip


  • D. R. Ramprasath Department of Orthopaedics, Institute of Orthopaedics and Traumatology, Coimbatore Medical College Hospital, Coimbatore, Tamil Nadu, India
  • D. Kamaraj Department of Orthopaedics, Institute of Orthopaedics and Traumatology, Coimbatore Medical College Hospital, Coimbatore, Tamil Nadu, India



Arthrodiastasis, Stiff hip, Adolescent, Joint distraction, Hip joint, Perthes disease


Arthrodiastasis (using external fixator and distraction) has been used for various pathologies including deformity correction/stiff hip/slipped capital femoral epiphysis. Historically this has been used for treatment of Perthes disease. The purpose of our study is to evaluate efficacy of arthrodiastasis in management of stiff hip. A 15 year old boy with stiff hip presented with complaints of pain in the left hip for past 6 months. Radiologically the left proximal femur was found to be deformed with metaphyseal widening, sclerosis and arthritic changes. Hip spanning external fixator using limb reconstruction system was done. Distraction was done at a rate of 1 mm/day. After 2 months, fixator was removed. Hip was mobilized under anaesthesia. Good range of all movements was achieved. Arthrodiastasis seems to be a good option in young adolescent in whom total hip replacement needs to be delayed as much as possible.


Luzo CAM, Guarniero R, Montenegro NB, de-Godoy RM Jr. Initial experience of use of an articulated external fixator in treating Legg-Calve-Perthes disease by means of arthrodiastasis during the active phase of the disease. Rev Bras Ortop. 2016;51(3);330-45.

Volkov MV, Oganesian OV. Restoration of function in the knee and elbow with a hinge-distractor apparatus. J Bone Joint Surg Am. 1975;57(5):591-600.

Krumins M, Kalnis J, Lacis G. Reconstuction of the proximal end of the femur after hematogenous osteomyelitis. Pediatr Orthop. 1993:13(1);63-7.

Canadell J Gonzales F, Barrios RH, Camillo S. Arthrodiastasis for stiff hips in young patients. Int Orthop. 1993;17(4):254-8.

Judet R, Judet T. Arthrolyse et arthroplastie sous distracteur articulaire. Rev Chir Orthop Reparatrice Appar Mot. 1978;64(5):353-65.

Cobb TK, Morrey BF. Use of distraction arthroplasty in unstable fracture dislocation of the elbow. Clin Orthop Relat Res. 1995;(312):201-10.

Kim SS, Lee CW, Kim HJ, Kim HH, Wang L. Treatment of Late-Onset Legg-Calve-Perthes Disease by Arthrodiastasis. Clin Orthop Surg. 2016;8(4):452-7.

Aldegheri R, Trivella G, Saleh M. Articulated distraction of the hip. In: De Bastani G, Apley AG, Goldberg A,eds. Orthofix external fixation in trauma and orthopaedics. London:Springer Verlag. 2000; 605-12.

Singh A, Srivastava RN, Shukla P, Pushkar A, Ali S. Management of Late Onset Perthes: Evaluation of Distraction by External Fixator-5-Year Follow-Up. Hindawi Publishing Corporation. 2014;1-6.

Sudesh P, Bali K, Mootha AK, Dhillon MS, Saini R. Arthrodiastasis and surgical containment in severe late-onset Perthes disease: An analysis of 14 patients. Acta Orthopaedica Belgica. 2010;76(3).

Weinstein SL. Long-term follow-up of pediatric orthopaedic conditions. Bone Joint Surg. 2000;82(A):980-90.






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