A shelf procedure at a follow-up of 75 years

Rajakulendran, Karthig; Strambi, Francesco; Buly, J.; Field, Richard E.

doi:10.1302/0301-620x.93b1.25287

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…However, an interposed articular capsule between the femoral head and ilium (in case of Chiari osteotomy) or bone graft (in shelf osteotomy) develops a cartilage metaplasia that could remember articular cartilage. 75,76…”

Section: Treatmentmentioning

confidence: 99%

Developmental dysplasia of the hip: update of management

et al. 2019

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The term ‘developmental dysplasia of the hip’ (DDH) includes a wide spectrum of hip alterations: neonatal instability; acetabular dysplasia; hip subluxation; and true dislocation of the hip. DDH alters hip biomechanics, overloading the articular cartilage and leading to early osteoarthritis. DDH is the main cause of total hip replacement in young people (about 21% to 29%). Development of the acetabular cavity is determined by the presence of a concentrically reduced femoral head. Hip subluxation or dislocation in a child will cause an inadequate development of the acetabulum during the remaining growth. Clinical screening (instability manoeuvres) should be done universally as a part of the physical examination of the newborn. After two or three months of life, limited hip abduction is the most important clinical sign. Selective ultrasound screening should be performed in any child with abnormal physical examination or in those with high-risk factors (breech presentation and positive family history). Universal ultrasound screening has not demonstrated its utility in diminishing the incidence of late dysplasia. Almost 90% of patients with mild hip instability at birth are resolved spontaneously within the first eight weeks and 96% of pathologic changes observed in echography are resolved spontaneously within the first six weeks of life. However, an Ortolani-positive hip requires immediate treatment. When the hip is dislocated or subluxated, a concentric and stable reduction without forceful abduction needs to be obtained by closed or open means. Pavlik harness is usually the first line of treatment under the age of six months. Hip arthrogram is useful for guiding the decision of performing a closed or open reduction when needed. Acetabular dysplasia improves in the majority due to the stimulus provoked by hip reduction. The best parameter to predict persistent acetabular dysplasia at maturity is the evolution of the acetabular index. Pelvic or femoral osteotomies should be performed when residual acetabular dysplasia is present or in older children when a spontaneous correction after hip reduction is not expected. Avascular necrosis is the most serious complication and is related to: an excessive abduction of the hip; a force closed reduction when obstacles for reduction are present; a maintained dislocated hip within the harness or spica cast; and a surgical open reduction.Cite this article: EFORT Open Rev 2019;4:548-556. DOI: 10.1302/2058-5241.4.180019

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Section: Treatmentmentioning

confidence: 99%

Developmental dysplasia of the hip: update of management

et al. 2019

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“…Extraordinary is the case report by Rajakulendran et al [28] who described an excellent outcome of shelf procedure after 75 years in a female patient operated on at the age of ten.…”

Section: Discussionmentioning

confidence: 97%

“…Migaud et al [11] evaluated 56 hips in 48 patients with a mean age of 32 years (range, 17-56) and a mean follow-up of 17 years (range, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Pre-operative joint space narrowing was observed in 32 of 56 shelf arthroplasties.…”

Section: Discussionmentioning

confidence: 99%

Bosworth hip shelf arthroplasty in adult dysplastic hips: ten to twenty three year results

Bartoníček

Vávra

Chochola

2012

International Orthopaedics (SICOT)

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Purpose Hip shelf arthroplasty is currently considered to be a salvage procedure. The aim of the study is to present outcomes of Bosworth hip shelf arthroplasty in adolescent dysplastic hips with a minimum ten-year follow-up. Methods The basic group comprised 25 hips in 18 patients with the mean age of 31 years (range, 16-52) at the time of operation. Subgroup A included 20 hips that were evaluated prior to operation as spherical, centric hips without osteoarthritic changes (acetabular dysplasia). The heterogeneous subgroup B comprised five hips. Of these, three hips were evaluated as aspheric, without osteoarthritic changes, and two hips as aspheric, with osteoarthritic changes of grade 2 according to Tönnis. In addition, two hips in subgroup B were evaluated as decentred (subluxated), one hip without and one hip with osteoarthritic changes. The mean follow-up was 15 years (range, ten-23). Results In subgroup A, the positive effect of operation had lasted at the time of the final follow-up for ten to 22 years postoperatively (average follow-up 14 years) in 19 hips. Only one female patient, 46 years old at the time of operation, developed hip osteoarthritis within ten years, that was treated by THA. In subgroup B, a lasting positive effect of operation was recorded in two cases at the time of the final follow-up (12 and 15 years). The third female patient with an aspheric and decentred hip developed severe hip osteoarthritis 21 years after shelf procedure that was treated by THA. In two patients who had hip osteoarthritis already before the operation, the positive effect of the shelf procedure survived over 13 and 20 years. Although hip osteoarthritis progressed, THA was performed as late as 15 and 23 years after the shelf procedure. The mean Harris hip score in 21 hips with a still functional hip shelf was 68 (range, 56-82) before and 90 (range, 76-100) after the surgery. Conclusion The best outcomes of Bosworth hip shelf arthroplasty may be expected in a dysplastic spherical centred hip without osteoarthritic changes. In the presence of asphericity, decentration and osteoarthritic changes, neither the effect of the surgery nor its survival can be clearly predicted.

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“…The Pavlik harness, potentially with supplemental bracing techniques, is first-line treatment for reducing a dislocated or subluxated hip and encouraging proper acetabular development [52,60]. Surgical techniques to alter and possibly normalize hip joint structure are available and valuable, although controversial [8,12,27,62]. In patients receiving surgical treatment for DDH, 31% required THA 45 years after the procedure [70].…”

Section: Presented By Young-jo Kim MD Phdmentioning

confidence: 99%

Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 1: Epidemiology, Early Development, and Cohorts From Around the World

Kim,

Agricola,

Kim

et al. 2023

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation, in partnership with the Hospital for Special Surgery, convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summarizes the recommendations and clinical research gaps gleaned from 5 presentations given in the “how hip osteoarthritis begins” session of the 2023 Hip Osteoarthritis Clinical Studies Conference, which took place on February 17 and 18, 2023, in New York City.

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A shelf procedure at a follow-up of 75 years

Cited by 5 publications

References 23 publications

Developmental dysplasia of the hip: update of management

Developmental dysplasia of the hip: update of management

Bosworth hip shelf arthroplasty in adult dysplastic hips: ten to twenty three year results

Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 1: Epidemiology, Early Development, and Cohorts From Around the World

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