Top

Published in:

01-04-2010 | Original Paper

Evaluation of acetabular versions after a curved periacetabular osteotomy for dysplastic hips

Authors: Jun Xie, Masatoshi Naito, Akira Maeyama

Published in: International Orthopaedics | Issue 4/2010

Abstract

The purpose of this study is to investigate the early clinical and radiographic findings related to acetabular orientation after a curved periacetabular osteotomy (CPO). 106 dysplastic hips of 88 patients underwent CPO were investigated retrospectively with an average follow-up of 3.6 years. Conventional anteroposterior radiographs were used to measure the radiographic findings and range of motion were used for clinical evaluations. A significant improvement was noted in radiographic measurements including lateral centre-edge angle, acetabular index, and acetabular angle of Sharp. However, a high rate of postoperative acetabular retroversion was observed (62% hips) and a marked decrease in free flexion was noted. The Tönnis scale revealed a one-grade progression in most retroversion hips. Acetabular retroversion is a high risk factor leading to degenerative osteoarthritis of hip. Therefore, special consideration must be taken in surgical planning and careful intraoperative confirmation is required whilst manoeuvring the acetabular fragment in CPO.

Ganz R, Klaue K, Vinh TS, Mast J (1988) A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. Clin Orthop Relat Res 232:26–36PubMed

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120PubMed

Harris W (1986) Etiology of osteoarthritis of the hip. Clin Orthop Relat Res 213:20–33PubMed

Kiyama T, Naito M, Shiramizu K, Shinoda T (2007) Postoperative acetabular retroversion causes posterior osteoarthritis of the hip. Int Orthop. doi:10.1007/s00264-007-0507-6

Maeyama A, Naito M, Moriyama S, Yoshimura I (2008) Evaluation of dynamic instability of dysplastic hip with use of triaxial accelerometry. J Bone Joint Surg Am 90:85–92CrossRefPubMed

Mast JW, Brunner RL, Zebrack J (2004) Recognizing acetabular version in the radiographic presentation of hip dysplasia. Clin Orthop Relat Res 418:48–53CrossRefPubMed

Myers SR, Eijer H, Ganz R (1999) Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res 363:93–99CrossRefPubMed

Naito M, Shiramizu K, Akiyoshi Y, Ezoe M, Nakamura Y (2005) Curved periacetabular osteotomy for treatment of dysplastic hip. Clin Orthop Relat Res 433:129–135CrossRefPubMed

Ninomiya S (1989) Rotational acetabular osteotomy for the severely dysplastic hip in the adolescent and young adult. Clin Orthop Relat Res 247:127–137PubMed

10.

Nozawa M, Maezawa K, Matsuda K, Kim S, Shitoto K, Kurosawa H (2008) Rotational acetabular osteotomy for advanced osteoarthritis of the hip joint with acetabular dysplasia. Int Orthop. doi:10.1007/s00264-008-0657-1

11.

Peters CL, Erickson JA, Hines JL (2006) Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am 88:1920–1926CrossRefPubMed

12.

Petersen DR, Brand RA, Davy DT (1997) Pelvic muscle and acetabular contact forces during gait. J Biomech 30:959–965CrossRef

13.

Reynolds D, Lucas J, Klaue K (1999) Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br 81:281–288CrossRefPubMed

14.

Salter RB (1961) Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg Am 43B:518–539

15.

Shinoda T, Naito M, Nakamura Y, Kiyama T (2007) Periacetabular osteotomy for the treatment of dysplastic hip with Perthes-like deformities. Int Orthop. doi:10.1007/s00264-007-0476-9

16.

Siebenrock KA, Schoeniger R, Ganz R (2003) Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am 85:278–286PubMed

17.

Siebenrock KA, Kalbermatten DF, Ganz R (2003) Effect of pelvic tilt on acetabular retroversion: a study of pelvis from cadavers. Clin Orthop Relat Res 407:241–248CrossRefPubMed

18.

Solomon L (1976) Patterns of osteoarthritis of the hip. J Bone Joint Surg Br 58:176–183PubMed

19.

Steel HH (1973) Triple osteotomy of the innominate bone. J Bone Joint Surg Am 55A:343–350

20.

Tönnis D, Arning A, Bloch M et al (1994) Triple pelvic osteotomy. J Pediatr Orthop 3:54–67

21.

Tönnis D, Heinecke A (1999) Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 81:1747–1770PubMed

22.

Visser JD, Jonkers A, Hillen B (1982) Hip joint measurements with computerized tomography. J Pediatr Orthop 2:143–146PubMed

Title: Evaluation of acetabular versions after a curved periacetabular osteotomy for dysplastic hips
Authors: Jun Xie
Masatoshi Naito
Akira Maeyama
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 4/2010
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-009-0785-2

At a glance: The STEP trials

Springer Medicine

Evaluation of acetabular versions after a curved periacetabular osteotomy for dysplastic hips

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2010

Coccygectomy with or without periosteal resection

Complications in shoulder arthroplasty: an analysis of 485 cases

Treatment of pathological humeral shaft fractures with intramedullary nailing. A retrospective study

Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients

Correlations of isokinetic measurements with tendon healing following open repair of rotator cuff tears

Fixation of basicervical and related fractures