Triple pelvic osteotomy for the treatment of symptomatic acetabular dysplasia in adolescents and adults: A review of 42 hips.

Mehmet Emre Baki, Atilla Abdioğlu, Hafız Aydın, Servet Kerimoğlu, Celal Baki

Abstract


We treated 42 hips with symptomatic acetabular dysplasia using triple pelvic osteotomy. The mean age of the patients was 20.7 years (12–47). The median follow-up was 50.3 months. The average Harris hip score improved from 74 to 92 points. Significant improvement from the preoperative to the latest follow-up evaluation was seen radiologically with reference to the center-edge angle, the anterior center-edge angle, the acetabular index and the femoral head extrusion index. Shenton’s line was intact in 9 hips before the operation and it was intact in 40 hips at the latest follow-up. The cross-over sign was present in 15 hips before the operation and it was present in one hip after the operation. In 12 hips the severity of osteoarthritis had improved at the latest follow-up. The results of this study demonstrated that triple pelvic osteotomy provides improved radiographic results and good symptomatic relief in acetabular dysplasia.


Keywords


Hip dysplasia, Acetabular dysplasia, Triple pelvic osteotomy

References


- Tönnis D. Congenital dysplasia and dislocation of the hip in children and adults. Berlin, Springer-Verlag, 1987, pp 356-57.

- Hailer NP, Soykaner L, Ackermann H, Rittmeister M. Triple osteotomy of the pelvis for acetabular dysplasia. J Bone Joint Surg 2005 ; 87-B : 1622-6.

- Vukasinovic Z, Spasovski D, Kralj-Iglic V, Marinkovic-Eric J, Seslija I, Zivkovic Z, Spasovski V. Impact of triple pelvic osteotomy on contact stress pressure distribution in the hip joint. Int Orthop 2013 ; 37 : 95-98.

- Garras DN, Crowder TT, Olson SA. Medium-term results of the Bernese periacetabular osteotomy in the treatment of symptomatic developmental dysplasia of the hip. J Bone Joint Surg 2007 ; 89-B : 721-4.

- Li YC, Wu KW, Huang SC, Wang TM, Kuo KN. Modified triple innominate osteotomy for acetabular dysplasia: for better femoral head medialization and coverage. J Pediatr Orthop B 2012 ; 21 : 193-99.

- Steel HH. Triple osteotomy of the innominate bone. J Bone Joint Surg 1973 ; 53-A : 343-50.

- Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. Clin Orthop 1988 ; 232 : 26-36.

- Tönnis D, Behrens K, Tscharani F. A modified technique of the triple pelvic osteotomy: early results. J Pediatr Orthop 1981 ; 1 : 241-49.

- Ninomiya S, Tagawa H. Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg 1984 ; 66-A : 430-6.

- Saito S, Takaoka K, Ono K. Tectoplasty for painful dislocation or subluxation of the hip. J Bone Joint Surg 1986 ; 68-B : 55-60.

- Eren A, Ömeroglu H, Güven M, Ugutmen E, Altintas F. Incomplete triple pelvic osteotomy for the surgical treatment of dysplasia of the hip in adolescents and adults. J Bone Joint Surg 2005 ; 87-B : 790-5.

- Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg 1969 ; 51-A : 737-55.

- Sharp IK. Acetabular dysplasia: the acetabular angle. J Bone Joint Surg 1961 ; 43-B : 268-72.

- Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint: with special reference to the complication of osteo-arthritis. Acta Chir Scand 1939 ; 83(Suppl 58) : 1-135.

- Delaunay S, Dussault RG, Kaplan PA, Alford BA. Radiographic measurements of dysplastic adult hips. Skeletal Radiol 1997 ; 26 : 75-81.

- Heyman CH, Herndon CH. Legg-Perthes disease; a method for the measurement of the roentgenographic result. J Bone Joint Surg 1950 ; 32-A : 767-78.

- 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 2006 ; 88-A : 1920-26.

- Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg 1973 ; 55-A : 1629-32.

- Hsin J, Saluja R, Eilert RE, Wiedel JD. Evaluation of the biomechanics of the hip following a triple osteotomy of the innominate bone. J Bone Joint Surg 1996 ; 78-A : 855-62.

- van Hellemondt GG, Sonneveld H, Schreuder MHE, Kooijman MAP, de Kleuver M. Triple osteotomy of the pelvis for acetabular dysplasia. J Bone Joint Surg 2005 ; 87-B : 911-15.

- Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year follow-up of Bernese periacetabular osteotomy. Clin Orthop 2008 ; 466 : 1633-44.

- Aminian A, Mahar A, Yassir W, Newton P, Wenger D. Freedom of acetabular fragment rotation following three surgical techniques for correction of congenital deformities of the hip. J Pediatr Orthop 2005 ; 25 : 10-13.

- Yasunaga Y, Iwamori H, Ikuta Y, Yamamoto S. Rotational acetabular osteotomy for advanced osteoarthrosis secondary to dysplasia of the hip. Arch Orthop Trauma Surg 1999 ; 119 : 253-57.

- Ito H, Tanino H, Yamanaka Y, Minami A, Matsuno T. Intermediate to long-term results of periacetabular osteotomy in patients younger and older than forty years of age. J Bone Joint Surg 2011 ; 93-A : 1347-54.

- Janssen D, Kalchschmidt K, Katthagen BD. Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip. Int Orthop 2009 ; 33 : 1555-59.

- Konya MN, Tuhanioglu Ü, Aslan A, Yıldırım T, Bursalı A, Sahin V, Demir B. A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia. (Article in Turkish) Eklem Hastalık Cerrahisi 2013 ; 24 : 96-101.

- Fujii M, Nakashima Y, Noguchi Y, Yamamoto T, Mawatari T, Motomura G, Iwamoto Y. Effect of intra-articular lesions on the outcome of periacetabular osteotomy in patients with symptomatic hip dysplasia. J Bone Joint Surg 2011 ; 93-B : 1449-56.

- Yasunaga Y, Yamasaki T, Matsuo T, Ishikawa M, Adachi N, Ochi M. Crossover sign after rotational acetabular osteotomy for dysplasia of the hip. J Orthop Sci 2010 ; 15 : 463-9.

- Mimura T, Mori K, Kawasaki T, Imai S, Matsusue Y. Triple pelvic osteotomy: report of our mid-term results and review of literature. World J Orthop 2014 ; 5 : 14-22.

- Tschauner C, Sylkin A, Hofmann S, Graf R. Painful nonunion after triple pelvic osteotomy. J Bone Joint Surg 2003 ; 85-B : 953-5.


Refbacks

  • There are currently no refbacks.


© 1950-2014 Acta Orthopaedica Belgica | Non-Profit Organization, All rights reserved
Sponsored by BVOT & SORBCOT