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Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip

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Abstract

Joint-preserving osteotomies are an established treatment for adult hip pain secondary to developmental dysplasia of the hip. However, their value for advanced osteoarthritis is unclear. Therefore this study addresses the question of long-term results of triple pelvic osteotomy in patients with second grade osteoarthritis. Thirty-two patients with second grade osteoarthritis secondary to developmental dysplasia of the hip before triple pelvic osteotomy were clinically and radiographically assessed 11.5 years postoperatively. Five patients required conversion to total hip replacement. Kaplan-Meier survivorship analysis predicted a survival rate of 85.3%. The mean Harris hip score increased significantly with more than 56% good or very good results. A preoperative BMI > 25 and Harris hip score < 70 resulted in worse outcome or early conversion into total hip arthroplasty. The results indicate that developmental dysplasia of the hip even in second grade osteoarthritis can be treated with triple pelvic osteotomy.

Résumé

dans les dysplasies douloureuses de la hanche, l’ostéotomie est un des traitements permettant de protéger l’articulation et de préserver l’avenir. Cependant, leur intérêt dans les arthroses évoluées n’est pas très clair. Cette étude a pour but d’évaluer les résultats à long terme d’une ostéotomie pelvienne chez des patients présentant une arthrose de hanche de stade 2. 32 patients présentant une arthrose de hanche de stade 2 secondaire à une dysplasie de hanche ont été évalués cliniquement et radiographiquement à 11,5 ans post-opératoire. 5 patients ont nécessité la conversion de l’ostéotomie par une prothèse totale de hanche. La courbe de survie selon Kaplan-Meier permet de prédire un taux de survie de 85,3%. Le score moyen de Harris augmente de façon significative avec plus de 56% de bons et très bons résultats. Un BMI > 25 et un score de Harris < 70 sont des facteurs prédictifs de mauvais résultats ou d’une conversion vers une prothèse totale de hanche. ces résultats permettent de penser que les arthroses de grade II secondaires à une dysplasie de hanche peuvent être traitées par une triple ostéotomie pelvienne.

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Authors and Affiliations

  1. Department of Pediatric Orthopaedic Surgery, University Hospital Basle, Post Box, CH-4005, Basle, Switzerland

    Dirk Janssen

  2. Department of Orthopaedic Surgery, Staedtisches Klinikum Dortmund gGmbH, Beurhausstr. 40, D-44137, Dortmund, Germany

    Klaus Kalchschmidt & Bernd-Dietrich Katthagen

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  1. Dirk Janssen
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  2. Klaus Kalchschmidt
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  3. Bernd-Dietrich Katthagen
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Correspondence to Dirk Janssen.

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Janssen, D., Kalchschmidt, K. & Katthagen, BD. Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip. International Orthopaedics (SICOT) 33, 1555–1559 (2009). https://doi.org/10.1007/s00264-008-0718-5

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  • DOI: https://doi.org/10.1007/s00264-008-0718-5

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