Anteverting periacetabular osteotomy for symptomatic acetabular retroversion: results at ten years.

Siebenrock, Klaus-Arno; Schaller, Claudio; Tannast, Moritz; Keel, Marius; Büchler, Lorenz (2014). Anteverting periacetabular osteotomy for symptomatic acetabular retroversion: results at ten years. Journal of bone and joint surgery - American volume, 96(21), pp. 1785-1792. Journal of Bone & Joint Surgery Inc. 10.2106/JBJS.M.00842

[img]
Preview
Text
1785.full.pdf - Published Version
Available under License Publisher holds Copyright.

Download (732kB) | Preview

BACKGROUND Acetabular retroversion is associated with pincer-type femoroacetabular impingement and can lead to hip osteoarthritis. We report the ten-year results of a previously described patient cohort that had corrective periacetabular osteotomy for the treatment of symptomatic acetabular retroversion. METHODS Clinical and radiographic parameters were assessed preoperatively and at two and ten years postoperatively. A Kaplan-Meier survivorship analysis of the twenty-two patients (twenty-nine hips) with a mean follow-up (and standard deviation) of 11 ± 1 years (range, nine to twelve years) was performed. In addition, a univariate Cox regression analysis was done with conversion to total hip arthroplasty as the primary end point and progression of the osteoarthritis, a fair or poor result according to the Merle d'Aubigné score, or the need for revision surgery as the secondary end points. RESULTS The mean Merle d'Aubigné score improved significantly from 14 ± 1.4 points (range, 12 to 17 points) preoperatively to 16.9 ± 0.9 points (range, 15 to 18 points) at ten years (p < 0.001). There were also significant improvements with regard to hip flexion (p = 0.003), internal rotation (p = 0.003), and adduction (p = 0.002) compared with the preoperative status. No significant increase of the mean Tönnis osteoarthritis score was seen at ten years (p = 0.06). The cumulative ten-year survivorship, with conversion to a total hip arthroplasty as the primary end point, was 100%. The cumulative ten-year survivorship in achievement of one of the secondary end points was 71% (95% confidence interval, 54% to 88%). Predictors for poor outcome were the lack of femoral offset creation and overcorrection of the acetabular version resulting in excessive anteversion. CONCLUSIONS Anteverting periacetabular osteotomy for acetabular retroversion leads to favorable long-term results with preservation of the native hip at a mean of ten years. Overcorrection resulting in excessive anteversion of the hip and omitting concomitant offset creation of the femoral head-neck junction are associated with an unfavorable outcome.

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:

Siebenrock, Klaus-Arno; Tannast, Moritz; Keel, Marius and Büchler, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0021-9355

Publisher:

Journal of Bone & Joint Surgery Inc.

Language:

English

Submitter:

Stefanie Zurbuchen

Date Deposited:

11 Feb 2015 08:16

Last Modified:

11 Feb 2015 08:16

Publisher DOI:

10.2106/JBJS.M.00842

PubMed ID:

25378505

BORIS DOI:

10.7892/boris.62956

URI:

https://boris.unibe.ch/id/eprint/62956

Actions (login required)

Edit item Edit item
Provide Feedback