scholarly journals Comparison Between Hip Arthroscopic Surgery and Periacetabular Osteotomy for the Treatment of Patients With Borderline Developmental Dysplasia of the Hip: A Systematic Review

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110074
Author(s):  
Yoichi Murata ◽  
Naomasa Fukase ◽  
Maitland Martin ◽  
Rui Soares ◽  
Lauren Pierpoint ◽  
...  
Keyword(s):  
Systematic Review ◽  
Periacetabular Osteotomy ◽  
Arthroscopic Surgery ◽  
Patient Characteristics ◽  
Developmental Dysplasia ◽  
Edge Angle ◽  
Center Edge ◽  
Lateral Center Edge Angle ◽  
Dysplasia Of The Hip ◽  
Center Edge Angle

Background: The treatment for borderline developmental dysplasia of the hip (BDDH) has historically been arthroscopic surgery or periacetabular osteotomy (PAO). As orthopaedic surgery is constantly evolving, a lack of comparison of outcomes for these 2 treatment methods could potentially be stalling the progression of treatment for patients with BDDH. Purpose: To evaluate the existing literature on patient characteristics, procedures, clinical outcomes, and failure rates for patients with BDDH and to determine whether PAO or hip arthroscopic surgery is a better treatment method for patients with BDDH. Study Design: Systematic review; Level of evidence, 4. Methods: Studies included were found using the following search words: “hip” and “borderline dysplasia,” “osteotomy” or “arthroscopy,” and “outcome” or “procedure.” Articles were included if they detailed participants of all sexes and ages, reported on isolated hips, and had patients diagnosed with BDDH. Results: A search was conducted across 3 databases, resulting in 469 articles for consideration, from which 12 total studies (10 on arthroscopic surgery and 2 on PAO) were chosen for a review. There were 6 studies that included patients with a lateral center-edge angle of 18° to 25°, while the remainder included patients with a lateral center-edge angle of 20° to 25°. All the studies reviewing arthroscopic surgery reported concomitant/accessory procedures, while the articles on the topic of PAO did not. It was determined that, whether treated using arthroscopic surgery or PAO, outcomes improved across all patient-reported outcome measures. Revision surgery was also common in both procedures. Conclusion: There is a lack of consensus in the literature on the best treatment option for patients with BDDH. Preoperative patient characteristics and concomitant injuries should be considered when evaluating which surgical procedure will result in the most favorable outcomes.

scholarly journals Periacetabular osteotomy with concomitant hip arthroscopy: A case series with 24 months minimum follow-up

Medwave ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. e8082-e8082
Author(s):  
Cristian Barrientos ◽  
Julián Brañes ◽  
Rodrigo Olivares ◽  
Rodrigo Wulf ◽  
Álvaro Martinez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hip Arthroscopy ◽  
Periacetabular Osteotomy ◽  
Case Series ◽  
Resonance Imaging ◽  
Edge Angle ◽  
Center Edge ◽  
Lateral Center Edge Angle ◽  
Center Edge Angle

Purpose To describe patient-reported outcomes, radiological results, and revision to total hip replacement in patients with hip dysplasia that underwent periacetabular osteotomy as isolated treatment or concomitant with hip arthroscopy. Methods Case series study. Between 2014 and 2017, patients were included if they complained of hip pain and had a lateral center-edge angle ≤ of 20°. Exclusion criteria included an in-maturate skeleton, age of 40 or older, previous hip surgery, concomitant connective tissue related disease, and Tönnis osteoarthritis grade ≥ 1. All patients were studied before surgery with an anteroposterior pelvis radiograph, false-profile radiograph, and magnetic resonance imaging. Magnetic resonance imaging was used to assess intraarticular lesions, and if a labral or chondral injury was found, concomitant hip arthroscopy was performed. The non-parametric median test for paired data was used to compare radiological measures (anterior and lateral center-edge angle, Tönnis angle, and extrusion index) after and before surgery. Survival analysis was performed using revision to total hip arthroplasty as a failure. Kaplan Meier curve was estimated. The data were processed using Stata. Results A total of 15 consecutive patients were included; 14 (93%) were female patients. The median follow-up was 3.5 years (range, 2 to 8 years). The median age was 20 (range 13 to 32). Lateral center-edge angle, Tönnis angle, and extrusion index correction achieved statistical significance. Seven patients (47%) underwent concomitant hip arthroscopy; three of them (47%) were bilateral (10 hips). The labrum was repaired in six cases (60%). Three patients (15%) required revision with hip arthroplasty, and no hip arthroscopy-related complications are reported in this series. Conclusion To perform a hip arthroscopy concomitant with periacetabular osteotomy did not affect the acetabular correction. Nowadays, due to a lack of conclusive evidence, a case by case decision seems more appropriate to design a comprehensive treatment.

scholarly journals Reduction by Pelvic External Fixator Followed by Innominate and Derotational Femoral Osteotomies for Late Presenting Bilateral Developmental Dysplasia of the Hip

2018 ◽  
Vol 25 (1) ◽  
pp. 76-81
Author(s):  
Teplenky Mikhail ◽  
Mekki Waleed
Keyword(s):  
External Fixator ◽  
Developmental Dysplasia ◽  
Femoral Osteotomy ◽  
Acetabular Index ◽  
Edge Angle ◽  
Center Edge ◽  
Challenging Situation ◽  
Dysplasia Of The Hip ◽  
Center Edge Angle

Introduction Bilateral developmental dysplasia of the hip is a challenging situation, closed and open reduction with or without pelvic and femoral osteotomies are all proposed. Methods We investigated the feasibility of closed ilizarov reduction combined with Salter and femoral osteotomy to provide stable concentric hips. Results We retrospectively reviewed 19 patients (38 hips). Tonnis Criteria, acetabular index and Center-edge angle were measured preoperatively and postoperatively. Acetabular index changed significantly (P<0,001), 80% were excellent or good according to Mckay, 25% were Ia and 69% were IIa Severin's criteria with at least three years follow-up. Conclusion The midterm overall results are favorable for application of this technique.

Prognostication in Developmental Dysplasia of the Hip Using the Ossific Nucleus Center Edge Angle

2018 ◽  
Vol 38 (5) ◽  
pp. 260-265 ◽  
Author(s):  
Gregory B. Firth ◽  
Anthony J.F. Robertson ◽  
Yammesh Ramguthy ◽  
Manoj Ramachandran ◽  
Anton Schepers
Keyword(s):  
Developmental Dysplasia ◽  
Edge Angle ◽  
Center Edge ◽  
Dysplasia Of The Hip ◽  
Center Edge Angle

scholarly journals Outcomes and complications of patients undergoing Salter’s innominate osteotomies for hip dysplasia: a systematic review of comparative studies

2021 ◽  
Author(s):  
Tushar Tejpal ◽  
Ajaykumar Shanmugaraj ◽  
Arnav Gupta ◽  
Nolan S Horner ◽  
Nicole Simunovic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Dysplasia ◽  
Developmental Dysplasia ◽  
Normal Range ◽  
Center Edge ◽  
Younger Age ◽  
Technical Factors ◽  
Dysplasia Of The Hip ◽  
Center Edge Angle

Abstract The purpose of this systematic review is to assess outcomes and complications of patients undergoing Salter’s innominate osteotomies (SIOs) for the correction of hip dysplasia along with patient and technical factors that can be optimized to improve outcomes after SIO. MEDLINE and EMBASE were searched from data inception to 9 October 2018. Data were presented descriptively. Twenty-seven studies were identified including 1818 hips (87.1%) treated with SIO (mean age of 2.1 ± 2.5 years and mean follow-up of 3.5 ± 5.0 years). Patients undergoing SIO had a post-operative center-edge angle (CEA) of 31.3° ± 5.3° and an acetabular index (AI) angle of 16.1° ± 5.2°. Patients undergoing SIO with pre-operative traction had significantly lower (P = 0.049) post-operative McKay criteria scores compared to patients without pre-operative traction. Patients undergoing SIO between the ages of 1.5–2 years had significantly better (P &lt; 0.05) post-operative McKay criteria scores compared to patients aged 4–6 years. The complication rate was 9.4% with avascular necrosis (2.5%) being most common. This review found that SIO for developmental dysplasia of the hip produces generally good post-operative clinical outcomes. The CEA and AI can be corrected to normal range after SIO. Patients may have superior outcomes if they have SIO at a younger age, were not treated with pre-operative traction and did not have untreated contralateral hip dysplasia. Outcomes appear to be similar between one-stage bilateral SIO and a two-stage procedure in the setting of bilateral hip dysplasia; however, more multicentered studies are needed to confirm these results.

Sign in / Sign up

Export Citation Format

Share Document