Noncemented total hip endoprosthesis implantation efficiency after previous Chiari pelvic osteotomy

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.

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Cost-Effectiveness of Minimally Invasive Total Hip Endoprosthesis Implantation as Compared with the Conventional Approach

IFMBE Proceedings - World Congress on Medical Physics and Biomedical Engineering 2018 ◽

10.1007/978-981-10-9038-7_14 ◽

2018 ◽

pp. 77-81

Author(s):

Tereza Lísalová ◽

Ondřej Gajdoš

Keyword(s):

Cost Effectiveness ◽

Minimally Invasive ◽

Conventional Approach ◽

Hip Endoprosthesis ◽

Total Hip ◽

Endoprosthesis Implantation

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Μελέτη επί της συμβολής της οστεοτομίας πυελού κατα Chiari στην αντιμετώπιση της οστεοαρθρίτιδος του δυσπλασικού ισχίου των ενηλίκων

10.12681/eadd/17497 ◽

2002 ◽

Author(s):

Νικόλαος Νικολακάκης

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Pelvic Osteotomy ◽

The Body ◽

Walking Ability ◽

Early Osteoarthritis ◽

Range Of Movement ◽

Total Hip ◽

Method Of Evaluation ◽

Chiari Pelvic Osteotomy

The results of 52 Chiari pelvic osteotomies for early osteoarthritis in dysplastic hips in 45 women are described.The patients were 18 to 53 years old average 35 years and the follow up was 1 to 16 years average 8 years. Five hips had undergone secondary total hip replacement till now. The outcome was good and fair in 84% and poor in 16%. We discuss the indications of this procedure. Criteria for the Chiari pelvic osteotomy in young adults with dysplastic hips with or without early osteoarthritis were clinically the pain, the limp, and the small restriction of the range of movement of the hip. Flexion at least 90° without fixed flexion deformity and radiologically dysplastic hip joint. The results were evaluated according to the Merle d’ Aubigne and Postel method of evaluation in relation to the pain, the walking ability and the range of movement of the hip before and after the operation. We noticed improvement of the walking ability in 84% of the patients, and the pain disappeared or decreased in 84% of the patients also, while the range of movement of the joint didn’t change substantially. The good results were because we increased the surface of contact between the head of the femur and the new acetabulum and because of the reduction of the power that acts on the joint and comes from the body weight, because of the medialisation of the joint, so the stresses on the joint were decreased. For osteoarthritis secondary to hip dysplasia, the Chiari pelvic osteotomy is an alternative procedure to early hip replacement, especially in younger patients. In our experience, the Chiari osteotomy delays the need for T.H.R. and improves the anatomical conditions for this operation, which has an uncertain outcome in the young patient and in cases of deficient acetabular bone stock, and in contrast to intertrochanteric osteotomy it facilitates the implantation of the acetabular part of a total hip replacement and the femoral part of the artificial joint is much easier to be inserted because we don’t disturb the upper femur.

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Total hip arthroplasty of dysplastic hip after previous Chiari pelvic osteotomy

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-006-0141-6 ◽

2006 ◽

Vol 126 (6) ◽

pp. 394-400 ◽

Cited By ~ 17

Author(s):

Yukihide Minoda ◽

Toru Kadowaki ◽

Mitsunari Kim

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Pelvic Osteotomy ◽

Total Hip ◽

Dysplastic Hip ◽

Chiari Pelvic Osteotomy

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Robot-assisted Total Hip Arthroplasty after Chiari Pelvic Osteotomy: A Case Report

Reconstructive Review ◽

10.15438/rr.6.3.130 ◽

2016 ◽

Vol 6 (3) ◽

Author(s):

Marius Dettmer ◽

Amir Pourmoghaddam ◽

Stefan W Kreuzer

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Pelvic Osteotomy ◽

Caucasian Woman ◽

Robot Assisted ◽

Short Term ◽

Total Hip ◽

Positive Effects ◽

Post Surgery ◽

Chiari Pelvic Osteotomy

Congenital hip dysplasia often requires surgical interventions in younger adults. 3D-navigated, robotic-assisted surgery for total hip arthroplasty may be beneficial in cases of pseudo-acetabulum and preceding treatments (Chiari Pelvic osteotomy) due to better pre-surgical planning and higher levels of precision associated with the technology, which may be associated with positive effects regarding short-term and long-term clinical outcomes.Here, we report the case of a 26-year-old Caucasian woman with a Crowe-IV dysplastic hip and pseudo-acetabulum. Earlier interventions included Chiari pelvic osteotomy, femoral osteotomy and femoral lengthening, which did not improve pain and function in the longer term. The surgical approach via robot-assisted surgery lead to positive outcomes in the short-term (four months post-surgery) and medium-term (17 months post-surgery) in this specific case.

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