Follow-up Results of Chiari Pelvic Osteotomy for Patients with Acetabular Dysplasia

1989 ◽  
pp. 35-54 ◽  
Author(s):  
Kazushi Hirohata ◽  
Ryoichi Shiba ◽  
Tomio Shimizu
2003 ◽  
Vol 52 (1) ◽  
pp. 10-17
Author(s):  
Taketoshi Kanazawa ◽  
Takahiro Okawa ◽  
Manabu Kubo ◽  
Masaru Kumagai ◽  
Shinichiro Kume ◽  
...  

2021 ◽  
pp. 112070002098815
Author(s):  
Dammerer Dietmar ◽  
Braito Matthias ◽  
Peter Ferlic ◽  
Kaufmann Gerhard ◽  
Juana Kosiol ◽  
...  

Introduction: The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD). Methods: A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years. Results: Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients. Conclusions: CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.


2007 ◽  
Vol 128 (1) ◽  
pp. 103-109 ◽  
Author(s):  
Shunji Nakano ◽  
Toshihiko Nishisyo ◽  
Daisuke Hamada ◽  
Hirofumi Kosaka ◽  
Kiminori Yukata ◽  
...  

2020 ◽  
pp. 112070002090183
Author(s):  
Josko Jelicic ◽  
Antea Buterin ◽  
Goran Vrgoc ◽  
Zeljko Butorac ◽  
Anton Tudor ◽  
...  

Background: The modern indications for Chiari pelvic osteotomy (CPO) have narrowed and the number of such operations performed has diminished markedly. So far published long-term experience with CPO indicate the fact that in selected patients satisfactory functional results can be achieved. The aim of this study was to investigate the parameters which influence CPO survival and its conversion into total hip arthroplasty (THA). Methods: This is a single-centre retrospective case-series study. In the period from 1976 to 2012, it included 172 CPO in 158 patients. Of those, in 43 patients (48 hips) the follow-up was discontinued, leaving 115 patients (124 hips) for final analyses. The median age at the time of the surgery was 34 years, and the mean duration of the follow-up was 19 years. Results: In 115 patients (124 CPO) included in the study, a total of 51 THA was performed in 49 patients. The median period between CPO and THA was 14 years. Conclusion: Supporting our results, we suggest that CPO should still be indicated in a selected group of younger patients even with advanced stage of hip osteoarthritis who prefer a joint-conserving procedure and consent to a predicted less optimal outcome.


1995 ◽  
Vol 66 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Henri Migaud ◽  
Antoine Duquennoy ◽  
Francois Gougeon ◽  
Christian Fontaine ◽  
Gilles Pasquier

1996 ◽  
Vol 16 (6) ◽  
pp. 769-773 ◽  
Author(s):  
Dana A. Mannor ◽  
Stuart L. Weinstein ◽  
Frederick R. Dietz

2019 ◽  
Vol 13 (2) ◽  
pp. 172-179 ◽  
Author(s):  
R. Badrinath ◽  
J. D. Bomar ◽  
D. R. Wenger ◽  
S. J. Mubarak ◽  
V. V. Upasani

Purpose Patients with developmental dysplasia of the hip (DDH) may require a pelvic osteotomy to treat acetabular dysplasia. The Pemberton osteotomy and modified San Diego acetabuloplasty are two options available when surgically treating DDH. The purpose of this study was to compare outcomes following the Pemberton and modified San Diego when treating patients with acetabular dysplasia in typical DDH. Methods We included 45 hips in the modified San Diego group and 38 hips in the Pemberton group. Hips with less than two years follow-up and patients with a neuromuscular diagnosis were excluded. Clinical outcomes were rated using the modified McKay criteria with radiographic outcomes graded using the Severin score. Avascular necrosis (AVN) was assessed using the Kalamchi and MacEwen criteria. Results Mean follow-up was 4.9 years (2.1 to 11.2). Both procedures produced similar decreases in the acetabular index (modified San Diego: 17.0˚ versus Pemberton: 15.2˚; p = 0.846). Most hips had good/excellent results using the modified McKay criteria (modified San Diego: 78%, Pemberton: 94%; p = 0.055). Most hips were rated as good/excellent on the Severin scale (modified San Diego: 100%, Pemberton: 97%, p = 0.485). The proportion of hips with AVN grade 2 or higher were similar between groups (modified San Diego: 0%, Pemberton: 3%; p = 0.458). Conclusion The modified San Diego acetabuloplasty is a safe and effective alternative to treat acetabular dysplasia in patients with typical DDH. By maintaining an intact medial cortex, acetabular reshaping can be customized to address each patient’s specific acetabular deficiency Level of evidence Level III retrospective comparison


1997 ◽  
Vol 9 (1) ◽  
pp. 15-18
Author(s):  
Akio Kobe ◽  
Toshiaki Yamada ◽  
Masao Yamaguchi ◽  
Hiroyuki Sasaki

1999 ◽  
Vol 03 (01) ◽  
pp. 1-10
Author(s):  
I. Y. Ok ◽  
C. H. Jeong ◽  
H. Y. Lee

The result of 27 Chiari pelvic osteotomy were analyzed to determine the efficacy of the operation in the treatment of subluxated and/or painful dysplastic hips. The length of follow-up ranged from 2 to 14 years. Eighteen patients had had developmental dysplasia of the hip; four sequelae of the septic hip; two, cerebral palsy and one had had poliomyelitis. The osteotomy can be done by power saw and osteotome. A large threaded K-wire was used for internal fixation. Bone graft was necessary even with the displacement of more than 50%. The overall result were: 12, excellent; 8, good; 5, fair; and 2 poor. In 11 patients, the osteotomy had to be displaced more than 50% to provide good coverage of the femoral head. There were no major complications such as sciatic nerve injury or delayed union. This procedure is most suited for the patient with painful hip dysplasia in whom a concentric reduction is not possible.


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