Total acetabular retroversion following pelvic osteotomy: presentation, management, and outcome

Tannast, Moritz; Pfander, Gilles; Steppacher, Simon D.; Mast, Jeffrey W.; Ganz, Reinhold (2013). Total acetabular retroversion following pelvic osteotomy: presentation, management, and outcome. Hip International, 23(Suppl.), pp. 14-26. Wichtig Editore 10.5301/hipint.5000089

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Acetabular retroversion following acetabular osteotomy in hips with dysplasia can negatively effect the outcome. Total retroversion, where the entire anterior rim is lateral to the posterior rim, is rare and can easily be missed on pelvic radiographs due to the lack of a crossover sign. We evaluated the clinical and radiographic presentation, the surgical management, and the outcome of hips with total acetabular retroversion. We retrospectively reviewed 26 patients (26 hips) with total retroversion following 15 periacetabular osteotomies (PAO), 10 triple type, and one Salter osteotomy. We obtained range of motion (ROM), anterior impingement test, Drehmann's sign, Merle d’Aubigné-Postel score, and Tönnis score for osteoarthrosis. Corrective surgery included 19 revision PAOs and seven total hip arthroplasties (THA). The mean follow-up was 4.7 ± 4.2 (range 0.5-13.8) years. Patients presented with a restricted ROM (flexion and internal rotation), a positive anterior impingement test, a positive Drehmann's sign, and a decreased Merle d'Aubigné-Postel score due to pain. Corrective surgery was performed after mean of 7 ± 5 (1-15) years. Complications for revision PAO and THA occurred in 37% and 29%, respectively. At follow-up, the Merle d'Aubigné-Postel score improved for both revision PAOs and THAs. The prevalence of a positive anterior impingement test and Drehmann's sign decreased for revision PAOs. There was a tendency for progression of OA in hips with revision PAO. Iatrogenic total acetabular retroversion following reorientation is a disabling condition for the patients. Corrective surgery including revision PAO and THA results in improved clinical outcome. However, these procedures are technically challenging and associated with high complication rates.

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:	Tannast, Moritz, Steppacher, Simon Damian
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1120-7000
Publisher:	Wichtig Editore
Language:	English
Submitter:	Stephanie Schmutz
Date Deposited:	04 Apr 2014 11:20
Last Modified:	05 Dec 2022 14:29
Publisher DOI:	10.5301/hipint.5000089
PubMed ID:	24062226
URI:	https://boris.unibe.ch/id/eprint/42681