Medium-term results of the Bernese periacetabular osteotomy in the treatment of symptomatic developmental dysplasia of the hip

被引:68
作者
Garras, D. N. [1 ]
Crowder, T. T. [1 ]
Olson, S. A. [1 ]
机构
[1] Duke Univ, Med Ctr, Dept Orthopaed, Durham, NC 27710 USA
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2007年 / 89B卷 / 06期
关键词
D O I
10.1302/0301-620X.89B6.18805
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
We studied the medium-term outcome of the Bernese periacetabular osteotomy in 52 patients (58 hips) with symptomatic developmental dysplasia of the hip and a mean age of 37.6 years (13 to 48). The operations were performed between 1993 and 2005 by the senior author with a mean follow-up of 66.7 months (13 to 153). There were 42 women (47 hips) and ten men (11 hips). Of these patients, 24 (30 hips) had an osteotomy on the right side and 22 (28 hips) on the left. Six patients had bilateral operations. The clinical outcome was assessed using the modified Merle d'Aubigne scale, and pre- and post-operative radiological evaluation using the modified Tonnis osteoarthritis score, the centre-edge angle, the acetabular index, the status of Shenton's line, and the cross-over sign. The mean centre-edge angle and the acetabular index were 14 degrees (2 degrees to 34 degrees) and 23.6 degrees (0 degrees to 40 degrees) before operation, and 36.6 degrees (16 degrees to 72 degrees) and 7.9 degrees (0 degrees to 28 degrees) after, respectively (p < 0.001, analysis of variance (ANOVA). Shenton's line was intact in 23 hips (39.6%) before operation and in 48 hips (82.8%) after. The cross-over sign was present in 31 hips (53.4%) before and in three hips (5.2%) after operation (p < 0.001, ANOVA). The total Merle d'Aubigne clinical score improved from a mean of 12.6 (9 to 15) to 16.0 (12 to 18) points (p < 0.001, ANOVA). Only four hips required subsequent total hip replacement. Our results indicate that the Bernese periacetabular osteotomy provides good symptomatic relief for patients with little to no arthritis (Tonnis type 0 or 1) with an underlying deformity that can be corrected to a position of a stable, congruent hip joint.
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页码:721 / 724
页数:4
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