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Clinical Orthopaedics and Related Research®
Erschienen in: Clinical Orthopaedics and Related Research® 9/2012

01.09.2012 | Clinical Research

Treatment of Adolescents with a Periacetabular Osteotomy After Previous Pelvic Surgery

verfasst von: Adriana De La Rocha, MS, Daniel J. Sucato, MD, MS, Kirsten Tulchin, MS, David A. Podeszwa, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 9/2012

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Abstract

Background

Although the success of the Bernese periacetabular osteotomy (PAO) has been reported for primary dysplasia, there is no study analyzing the radiographic, functional, and gait results of the PAO to correct residual hip dysplasia after previous pelvic surgery.

Questions/purposes

We assessed (1) radiographic and (2) functional and gait outcomes of patients treated with a PAO after previous pelvic surgery (PPSx) and compared their results with results of patients with no previous surgery (NPSx) to determine whether the PAO was equally effective in patients with revision pelvic surgery.

Methods

Twenty-nine dysplastic hips in 26 patients (average age, 16.3 years) were included: 13 in the PPSx group and 13 in the NPSx group. Radiographic parameters included the lateral center-edge angle, acetabular index, and femoral head extrusion index measured preoperatively and at 6 months and 1 year. We assessed preoperative and postoperative function using the Harris hip score (HHS). Preoperative and postoperative gait analysis included the hip abductor impulse.

Results

Improvements in groups were seen from preoperatively to 1 year postoperatively for the lateral center-edge angle, acetabular index, and femoral head extrusion index without differences between groups. The modified HHSs improved at 6 months and were maintained at 1 year for patients in both groups without differences between groups. The hip abductor impulse returned to preoperative values at 6 months in the NPSx group but not until 1 year in the PPSx group.

Conclusions

The Bernese PAO is effective in providing similar final radiographic and functional results, however, a trend toward decreased hip flexion and abduction power at 1 year was seen with previous pelvic surgery.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Armiger RS, Armand M, Tallroth K, Lepisto J, Mears SC. Three-dimensional mechanical evaluation of joint contact pressure in 12 periacetabular osteotomy patients with 10-year follow-up. Acta Orthop. 2009;80:155–161.PubMedCrossRef
2.
Biedermann R, Donnan L, Gabriel A, Wachter R, Krismer M, Behensky H. Complications and patient satisfaction after periacetabular pelvic osteotomy. Int Orthop. 2008;32:611–617.PubMedCrossRef
3.
Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL. Medial translation of the hip joint center associated with the Bernese periacetabular osteotomy. Iowa Orthop J. 2004;24:43–48.PubMed
4.
Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL. Periacetabular osteotomy for the treatment of severe acetabular dysplasia. J Bone Joint Surg Am. 2005;87:254–259.PubMedCrossRef
5.
Clohisy JC, Nunley RM, Curry MC, Schoenecker PL. Periacetabular osteotomy for the treatment of acetabular dysplasia associated with major aspherical femoral head deformities. J Bone Joint Surg Am. 2007;89:1417–1423.PubMedCrossRef
6.
Czubak JB, Tyrakowski M, Pietrzak S. Periacetabular Ganz osteotomy in the treatment of hip dysplasia in adolescent and young adults with previous hip surgery in childhood. J Bone Joint Surg Br. 2009;91(suppl I):29.
7.
Davey JP, Santore RF. Complications of periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:33–37.PubMedCrossRef
8.
El-Sayed MM. Single-stage open reduction, Salter innominate osteotomy, and proximal femoral osteotomy for the management of developmental dysplasia of the hip in children between the ages of 2 and 4 years. J Pediatr Orthop B. 2009;18:188–196.PubMedCrossRef
9.
Enad JG, Loomis LL. Primary patellar tendon repair and early mobilization: results in an active-duty population. J South Orthop Assoc. 2001;10:17–23.PubMed
10.
Endo H, Mitani S, Senda M, Kawai A, McCown C, Umeda M, Miyakawa T, Inoue H. Three-dimensional gait analysis of adults with hip dysplasia after rotational acetabular osteotomy. J Orthop Sci. 2003;8:762–771.PubMedCrossRef
11.
Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. Clin Orthop Relat Res. 1988;232:26–36.PubMed
12.
Heyman CH, Herndon CH. Legg-Perthes disease: a method for the measurement of the roentgenographic result. J Bone Joint Surg Am. 1950;32:767–778.PubMed
13.
Hussell JG, Mast JW, Mayo KA, Howie DW, Ganz R. A comparison of different surgical approaches for the periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:64–72.PubMed
14.
Hussell JG, Rodriguez JA, Ganz R. Technical complications of the Bernese periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:81–92.PubMed
15.
Katz DA, Kim YJ, Millis MB. Periacetabular osteotomy in patients with Down’s syndrome. J Bone Joint Surg Br. 2005;87:544–547.PubMedCrossRef
16.
Kotz R, Chiari C, Hofstaetter JG, Lunzer A, Peloschek P. Long-term experience with Chiari’s osteotomy. Clin Orthop Relat Res. 2009;467:2215–2220.PubMedCrossRef
17.
Lequesne M, de Seze S. [False profile of the pelvis: a new radiographic incidence for the study of the hip: its use in dysplasias and different coxopathies] [in French]. Rev Rhum Mal Osteoartic. 1961;28:643–652.PubMed
18.
MacDonald SJ, Hersche O, Ganz R. Periacetabular osteotomy in the treatment of neurogenic acetabular dysplasia. J Bone Joint Surg Br. 1999;81:975–978.PubMedCrossRef
19.
Maeyama A, Naito M, Moriyama S, Yoshimura I. Periacetabular osteotomy reduces the dynamic instability of dysplastic hips. J Bone Joint Surg Br. 2009;91:1438–1442.PubMedCrossRef
20.
Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fractures: a prospective study. J Gerontol. 1990; 45:M101–M107.PubMed
21.
Massie WK, Howorth MB. Congenital dislocation of the hip: Part I. Method of grading results. J Bone Joint Surg Am. 1950;32:519–531.PubMed
22.
Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M. Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome: surgical technique. J Bone Joint Surg Am. 2010;92(suppl 1):115–129.PubMedCrossRef
23.
Mayo KA, Trumble SJ, Mast JW. Results of periacetabular osteotomy in patients with previous surgery for hip dysplasia. Clin Orthop Relat Res. 1999;363:73–80.PubMedCrossRef
24.
Mechlenburg I, Nyengaard JR, Romer L, Soballe K. Changes in load-bearing area after Ganz periacetabular osteotomy evaluated by multislice CT scanning and stereology. Acta Orthop Scand. 2004;75:147–153.PubMedCrossRef
25.
Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip: a study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77:985–989.PubMed
26.
Nakamura T, Yamaura M, Nakamitu S, Suzuki K. The displacement of the femoral head by rotational acetabular osteotomy: a radiographic study of 97 subluxated hips. Acta Orthop Scand. 1992;63:33–36.PubMedCrossRef
27.
Pedersen EN, Alkjaer T, Soballe K, Simonsen EB. Walking pattern in 9 women with hip dysplasia 18 months after periacetabular osteotomy. Acta Orthop. 2006;77:203–208.PubMedCrossRef
28.
Pedersen EN, Simonsen EB, Alkjaer T, Soballe K. Walking pattern in adults with congenital hip dysplasia: 14 women examined by inverse dynamics. Acta Orthop Scand. 2004;75:2–9.PubMedCrossRef
29.
Peters CL, Erickson JA, Hines JL. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am. 2006;88:1920–1926.PubMedCrossRef
30.
Romano CL, Frigo C, Randelli G, Pedotti A. Analysis of the gait of adults who had residua of congenital dysplasia of the hip. J Bone Joint Surg Am. 1996;78:1468–1479.PubMed
31.
Ruchelsman DE, Feldman DS. Minimizing osteotomy related complications for abductor sparing periacetabular osteotomy using C-arm image intensification. Orthopedics. 2007;30:467–471.PubMed
32.
Salter RB. Role of innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip in the older child. J Bone Joint Surg Am. 1966;48:1413–1439.PubMed
33.
Salter RB, Dubos JP. The first fifteen year’s personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin Orthop Relat Res. 1974;98:72–103.PubMedCrossRef
34.
Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–1644.PubMedCrossRef
35.
Sucato DJ. Treatment of late dysplasia with Ganz osteotomy. Orthop Clin North Am. 2006;37:161–171, vi.
36.
Sucato DJ, Tulchin K, Shrader MW, DeLaRocha A, Gist T, Sheu G. Gait, hip strength and functional outcomes after a Ganz periacetabular osteotomy for adolescent hip dysplasia. J Pediatr Orthop. 2010;30:344–350.PubMedCrossRef
37.
Thawrani D, Sucato DJ, Podeszwa DA, De La Rocha A. Complications associated with the Bernese periacetabular osteotomy for hip dysplasia in adolescents. J Bone Joint Surg Am. 2010;92:1707–1714.PubMedCrossRef
38.
Tippet SR. Returning to sports after periacetabular osteotomy for developmental dysplasia of the hip. N Am J Sports Phys Ther. 2006;1:32–39.
39.
Tönnis D, Behrens K, Tscharani F. A modified technique of the triple pelvic osteotomy: early results. J Pediatr Orthop. 1981;1:241–249.PubMedCrossRef
40.
Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL. Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am. 1995;77:73–85.PubMed
41.
Trumble SJ, Mayo KA, Mast JW. The periacetabular osteotomy: minimum 2 year followup in more than 100 hips. Clin Orthop Relat Res. 1999;363:54–63.PubMedCrossRef
42.
Valenzuela RG, Cabanela ME, Trousdale RT. Sexual activity, pregnancy, and childbirth after periacetabular osteotomy. Clin Orthop Relat Res. 2004;418:146–152.PubMedCrossRef
43.
Vengust R, Antolic V, Kralj-Iglic V, Iglic A, Zupanc O. Biochemical aspects of Salter’s osteotomy for treatment of acetabular dysplasia. Pflugers Arch. 2000;440(5 suppl):R166–R167.PubMedCrossRef
44.
Wainwright D. The shelf operation for hip dysplasia in adolescence. J Bone Joint Surg Br. 1976;58:159–163.PubMed
45.
Wiberg G. Studies in dysplastic acetabulum and congenital subluxation of the hip joint with special reference to the complication of osteoarthritis. Acta Chir Scand. 1939;83(suppl 58):1–135.
46.
Yanagimoto S, Hotta H, Izumida R, Sakamaki T. Long-term results of Chiari pelvic osteotomy in patients with developmental dysplasia of the hip: indications for Chiari pelvic osteotomy according to disease stage and femoral head shape. J Orthop Sci. 2005;10:557–563.PubMedCrossRef
Metadaten
Titel
Treatment of Adolescents with a Periacetabular Osteotomy After Previous Pelvic Surgery
verfasst von
Adriana De La Rocha, MS
Daniel J. Sucato, MD, MS
Kirsten Tulchin, MS
David A. Podeszwa, MD
Publikationsdatum
01.09.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 9/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2298-3

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