Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH

Albers, Christoph; Steppacher, Simon Damian; Ganz, Reinhold; Tannast, Moritz; Siebenrock, Klaus-Arno (2013). Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH. Clinical orthopaedics and related research, 471(5), pp. 1602-1614. Springer 10.1007/s11999-013-2799-8

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BACKGROUND Although periacetabular osteotomy (PAO) for developmental dysplasia of the hip (DDH) provides conceptual advantages compared with other osteotomies and reportedly is associated with joint survivorship of 60% at 20 years, the beneficial effect of proper acetabular reorientation with concomitant arthrotomy and creation of femoral head-neck offset on 10-year hip survivorship remains unclear. QUESTIONS/PURPOSES We asked the following questions: (1) Does the 10-year survivorship of the hip after PAO improve with proper acetabular reorientation and a spherical femoral head; (2) does the Merle d'Aubigné-Postel score improve; (3) can the progression of osteoarthritis (OA) be slowed; and (4) what factors predict conversion to THA, progression of OA, or a Merle d'Aubigné-Postel score less than 15 points? METHODS We retrospectively reviewed 147 patients who underwent 165 PAOs for DDH with two matched groups: Group I (proper reorientation and spherical femoral head) and Group II (improper reorientation and aspherical femoral head). We compared the Kaplan-Meier survivorship, Merle d'Aubigné-Postel scores, and progression of OA in both groups. A Cox regression analysis (end points: THA, OA progression, or Merle d'Aubigné-Postel score less than 15) was performed to detect factors predicting failure. The minimum followup was 10 years (median, 11 years; range, 10-14 years). RESULTS An increased survivorship was found in Group I. The Merle d'Aubigné-Postel score did not differ. Progression of OA in Group I was slower than in Group II. Factors predicting failure included greater age, lower preoperative Merle d'Aubigné-Postel score, and the presence of a Trendelenburg sign, aspherical head, OA, subluxation, postoperative acetabular retroversion, excessive acetabular anteversion, and undercoverage. CONCLUSIONS Proper acetabular reorientation and the creation of a spherical femoral head improve long-term survivorship and decelerate OA progression in patients with DDH.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Albers, Christoph; Steppacher, Simon Damian; Tannast, Moritz and Siebenrock, Klaus-Arno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0009-921X

Publisher:

Springer

Language:

English

Submitter:

Stephanie Schmutz

Date Deposited:

24 Jan 2014 08:45

Last Modified:

13 Jul 2015 15:47

Publisher DOI:

10.1007/s11999-013-2799-8

PubMed ID:

23354462

Uncontrolled Keywords:

Orthopedics, Surgical Orthopedics, Medicine/Public Health, general, Surgery, Sports Medicine, Conservative Orthopedics

BORIS DOI:

10.7892/boris.39911

URI:

https://boris.unibe.ch/id/eprint/39911

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