Long-Term Follow-up of Chiari Pelvic Osteotomy in Myelomeningocele

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


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.


2001 ◽  
Vol 14 (02) ◽  
pp. 69-77 ◽  
Author(s):  
T. M. Lenehan ◽  
J. Harari ◽  
R. Gurevitch ◽  
B. Rivers ◽  
G. B. Tarvin ◽  
...  

SummaryThe objective of our study was to investigate, retrospectively, the role of triple pelvic osteotomy in the management of traumatic coxofemoral luxation. Nineteen patients were identified from medical record data and four dogs returned for long-term physical, goniometric and radiographic evaluation. Seventeen of nineteen dogs had maintenance of reduction of the hip. Due to poor outcome, two of these seventeen dogs required salvage procedures. Three of four dogs that returned for long-term follow-up, owner evaluation, radiographic scoring, and physical examination had satisfactory results. These four dogs had manual goniometric evaluations performed on the affected side, and the contralateral hip. A paired student t-test was used for statistical analysis, and internal rotation was the only value which was significantly (p d0.05) different between the two sides. Reduction alone is not a representation of success when evaluating open management of coxofemoral luxation, because two dogs with poor limb function necessitated femoral head and neck excision for limb salvage. The TPO does have a role in the treatment of traumatic coxofemoral luxation, but may not be sufficient in cases involving congenital dysplasia and/or intraarticular fractures.Triple pelvic osteotomy is a successful means of mitigating the sequela of congenital hip subluxation. This surgical technique can be used to manage dogs with traumatic coxofemoral luxation. There was an indication in this study that reduction alone is not a satisfactory means of evaluating management of traumatic coxofemoral luxation. Dogs with congenital dysplasia or intra-articular fractures associated with traumatic luxation may require alternate methods of reduction.


1996 ◽  
Vol 45 (2) ◽  
pp. 605-609
Author(s):  
Yoshiyasu Taniguchi ◽  
Shinya Maki ◽  
Yujiro Hamasato ◽  
Kazuyuki Okamura ◽  
Yasuhiro Babaguchi ◽  
...  

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.


2001 ◽  
Vol 120 (5) ◽  
pp. A397-A397
Author(s):  
M SAMERAMMAR ◽  
J CROFFIE ◽  
M PFEFFERKORN ◽  
S GUPTA ◽  
M CORKINS ◽  
...  

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