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Archives of Orthopaedic and Trauma Surgery

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Open Access 18-08-2021 | Hip Dysplasia | Orthopaedic Surgery

Fixation stability and implant-associated complications in periacetabular osteotomy: a comparison of screw and K-wire fixation

Authors: Vincent Justus Leopold, Juana Conrad, Robert Karl Zahn, Christian Hipfl, Carsten Perka, Sebastian Hardt

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2023

Abstract

Aims

The aim of this study was to compare the fixation stability and complications in patients undergoing periacetabular osteotomy (PAO) with either K-wire or screw fixation.

Patients and methods

We performed a retrospective study to analyze a consecutive series of patients who underwent PAO with either screw or K-wire fixation. Patients who were treated for acetabular retroversion or had previous surgery on the ipsilateral hip joint were excluded. 172 patients (191 hips: 99 K-wire/92 screw fixation) were included. The mean age at the time of PAO was 29.3 years (16–48) in the K-wire group and 27.3 (15–45) in the screw group and 83.9% were female. Clinical parameters including duration of surgery, minor complications (soft tissue irritation and implant migration) and major complications (implant failure and non-union) were evaluated. Radiological parameters including LCE, TA and FHEI were measured preoperatively, postoperatively and at 3-months follow-up.

Results

Duration of surgery was significantly reduced in the K-wire group with 88.2 min (53–202) compared to the screw group with 119.7 min (50–261) (p < 0.001). Soft tissue irritation occurred significantly more often in the K-wire group (72/99) than in the screw group (36/92) (p < 0.001). No group showed significantly more implant migration than the other. No major complications were observed in either group. Postoperative LCE, TA and FHEI were improved significantly in both groups for all parameters (p = < 0.0001). There was no significant difference for initial or final correction for the respective parameters between the two groups. Furthermore, no significant difference in loss of correction was observed between the two groups for the respective parameters.

Conclusion

K-wire fixation is a viable and safe option for fragment fixation in PAO with similar stability and complication rates as screw fixation. An advantage of the method is the significantly reduced operative time. A disadvantage is the significantly higher rate of implant-associated soft tissue irritation, necessitating implant removal.

Level of evidence

III, retrospective trial.

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Title: Fixation stability and implant-associated complications in periacetabular osteotomy: a comparison of screw and K-wire fixation
Authors: Vincent Justus Leopold
Juana Conrad
Robert Karl Zahn
Christian Hipfl
Carsten Perka
Sebastian Hardt
Publication date: 18-08-2021
Publisher: Springer Berlin Heidelberg
Keyword: Hip Dysplasia
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 2/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04112-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Fixation stability and implant-associated complications in periacetabular osteotomy: a comparison of screw and K-wire fixation

Abstract

Aims

Patients and methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aims

Patients and methods

Results

Conclusion

Level of evidence

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