A New Minimally Invasive Transsartorial Approach for Periacetabular Osteotomy

Troelsen, Anders; Elmengaard, Brian; Søballe, Kjeld

doi:10.2106/jbjs.f.01399

Cited by 93 publications

(108 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Different types of surgical approaches influence PAO morbidity [8,23,27]. A transartorial less invasive technique has been reported as an alternative to the classic approach [24]. However, the limited exposure increases the technical complexity of surgery and may compromise the operative accuracy, negatively affect acetabular reorientation, and increase the risk of complications.…”

Section: Discussionmentioning

confidence: 99%

“…However, their study was a review article that did not report any clinical, functional, or radiographic results nor did they compare the technique with the classic approach. Troelsen et al [24] compared the ilioinguinal approach with a less invasive transartorial approach that preserves the rectus femoris attachment. Although they reported no differences in short-term hip survival rates without conversion to hip arthroplasty, there were no specific hip pain and functional outcomes in their study.…”

Section: Discussionmentioning

confidence: 99%

“…Since the original description, there have been several reports describing different surgical approaches to perform a PAO. These include the ilioinguinal approach [8,17,23,27], a direct anterior approach without abductor dissection [13], and a ''minimally invasive transsartorial approach'' [24]. However, there are few studies comparing clinical and functional outcomes between these different approaches [8,23].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Bernese Periacetabular Osteotomy: Is Transection of the Rectus Femoris Tendon Essential?

Novais

Kim

Carry

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background The Bernese periacetabular osteotomy (PAO) traditionally is performed using the iliofemoral or the ilioinguinal approach with transection of the rectus femoris tendon attachments. Although a rectus-preserving approach has been developed, there is limited direct comparison data regarding the surgical safety, radiographic correction, and improvement in hip pain and function between the rectus-preserving and the classic approaches. Questions/purposes The purposes of this study were to determine whether preserving the rectus femoris tendon attachment would (1) reduce intraoperative blood loss and length of surgery; (2) improve Harris hip scores (HHS); (3) decrease the rate of complications; and (4) affect the radiographic correction when compared with the classic approach. Methods A retrospective matched cohort study was used to compare the endpoints listed above after PAO using a rectus-preserving approach versus the classic approach. Operative blood loss, preoperative and postoperative hematocrit, duration of surgery, HHS, and postoperative complications were recorded for the two groups. Pelvic radiographs were reviewed for measurement of the lateral center-edge angle, anterior center-edge angle, and Tönnis acetabular inclination angle. A total of 64 patients were included (32 in each group). Followup was at a minimum of 1 year (mean, 20 months; range, 13-44 months). Results Blood loss (p = 0.2405), hematocrit change (p = 0.3277), and operative time (p = 0.3960) were similar between groups. At latest followup, the HHS improved in the rectus-preserving (mean improvement, 25; 95% CI, 21-29; p \ 0.0001) and control groups (mean improvement, 21; 95% CI, 17-25; p \ 0.0001) with no difference in HHS improvement between the groups (mean difference, 4.3; 95% CI, À1.6 to 10.1; p = 0.1523). The complication rate was 12.5% (four of 32) in the rectus-preserving group and 25% (eight of 32) in the classic approach groups, respectively (p = 0.2002). The rectus-preserving approach allowed for similar lateral center-edge angle (p = 0.4463), anterior center-edge angle (p = 0.0936), and Tönnis angle (p = 0.7953) improvement when compared with the classic approach. Conclusions The rectus-preserving approach for PAO is as safe and effective as the classic approach to achieve radiographic correction and HHS improvement at minimum 1 year. Additional investigation is needed to determine whether the rectus-preserving approach allows for improvement in functional recovery including hip flexion strength.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Bernese Periacetabular Osteotomy: Is Transection of the Rectus Femoris Tendon Essential?

Novais

Kim

Carry

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…The authors stated that adequate corrections can be achieved with minimal complications. However, these results have not been duplicated [14].…”

mentioning

confidence: 93%

The Bernese periacetabular osteotomy for treatment of adult hip dysplasia

McKinley

2010

Skeletal Radiol

View full text Add to dashboard Cite

“…Transsartorial periacetabular osteotomy (PAO) [24] is performed in young patients with hip dysplasia to relieve hip pain and increase hip-related physical function [5,6]. Use of PAO may help postpone or prevent hip osteoarthritis (OA), but to our knowledge, no studies randomizing patients to either PAO or conservative treatment have been done, therefore we do not know whether PAO directly affects the development or progression of OA in patients with hip dysplasia.…”

Section: Introductionmentioning

confidence: 99%

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

Mechlenburg

Nyengaard

Gelineck

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Periacetabular osteotomy (PAO) may affect cartilage thickness and cyst volume in patients with hip dysplasia. However, as no studies randomizing patients to either PAO or conservative treatment have been performed, to our knowledge, it is unknown if PAO directly affects the development or progression of osteoarthritis in patients with hip dysplasia. Questions/purposes We investigated (1) changes of cartilage thickness in the hip after PAO; (2) how many patients had subchondral bone cysts in the acetabulum or femoral head; (3) changes in cyst volume; and (4) patients' hip function and pain after PAO. Patients and Methods In this prospective study, 26 patients (22 women and four men) with hip dysplasia were enrolled with the goal of having MRI of the hip before undergoing PAO and again at 1, 2 1 .2, and 10 years after PAO. Of the 26 patients, 17 (65%) underwent complete followup 10 years after PAO, whereas nine could not be included. Of those nine, three had undergone THA, three had substantial hip symptoms, and three were lost to followup. Thickness of acetabular and femoral cartilage and volume of subchondral bone cysts were estimated in the remaining 17 patients. Ten years postoperatively, the patients' Hip disability and Osteoarthritis Outcome Scores (HOOS) were collected. Results Preoperatively, the mean thickness of the acetabular cartilage was 1.38 ± 0.14 mm compared with 1.43 ± 0.07 mm 10 years postoperatively (p = 0.73). The mean thickness of the femoral cartilage preoperatively was 1.37 ± 0.20 mm compared with 1.30 ± 0.07 mm 10 years postoperatively (p = 0.24). Seven patients had an increase in cyst volume, six had a decrease, and four had no cysts to start with and remained without cysts. Preoperatively, the median total cyst volume per patient was 6.0 cm 3 (range, 1.6-188.3 cm 3 ) compared with 2.9 cm 3 (range, 0.7-8.2 cm 3 ) (p = 0.18) at 10 years followup. At 10 years, the mean subscores for the HOOS were: pain, 79 ± 16;

show abstract

A New Minimally Invasive Transsartorial Approach for Periacetabular Osteotomy

Cited by 93 publications

References 25 publications

The Bernese Periacetabular Osteotomy: Is Transection of the Rectus Femoris Tendon Essential?

The Bernese Periacetabular Osteotomy: Is Transection of the Rectus Femoris Tendon Essential?

The Bernese periacetabular osteotomy for treatment of adult hip dysplasia

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

Contact Info

Product

Resources

About