Approach to and Exposure of the Hip Joint for Mold Arthroplasty

Smith-Petersen, M. N.

doi:10.2106/00004623-194931010-00003

Cited by 268 publications

(111 citation statements)

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“…The survivorship of hips with an arthrotomy was 87% (95% CI, 77%-98%) versus 77% (95% CI, 67%-87%) without an arthrotomy after 10 years followup. The dynamic intraoperative assessment, however, is only possible through a capsulotomy with a (modified) Smith-Petersen approach [32]. Other approaches such as the classic ilioinguinal [20] or the more recently described transsartorial approach [42] do not offer access for this visual evaluation.…”

Section: Discussionmentioning

confidence: 99%

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Impingement Adversely Affects 10-year Survivorship After Periacetabular Osteotomy for DDH

Albers

Steppacher

Ganz

et al. 2013

Clinical Orthopaedics &Amp; Related Research

210

228

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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)

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Section: Discussionmentioning

confidence: 99%

“…Internal rotation* (°) 2 8± 19 (À50 to 70) [22][23][24][25][26][27][28][29][30][31][32][33][34] There were no patients without clinical examination or telephone followup. Clinical evaluations of the patients in both study groups were performed preoperatively and at the 10-year followups.…”

Section: Introductionmentioning

confidence: 99%

Impingement Adversely Affects 10-year Survivorship After Periacetabular Osteotomy for DDH

Albers

Steppacher

Ganz

et al. 2013

Clinical Orthopaedics &Amp; Related Research

210

228

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“…The procedure is performed through a modified SmithPetersen approach [47]. The skin incision starts at the iliac crest about 5-7 cm proximal of the anterior superior iliac spine (ASIS).…”

Section: Technique Of Paomentioning

confidence: 99%

Periacetabular osteotomy: a review of swiss experience

Büchler

Beck

2014

Curr Rev Musculoskelet Med

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Symptomatic dysplasia of the hip and acetabular retroversion are possible causes of osteoarthritis in the young adult. Surgical management with reorientation of the acetabulum allows causal therapy of the deformity and preservation of the native hip joint. The Ganz' periacetabular osteotomy permits a free 3-dimensional reorientation of the acetabulum and respects the blood supply of the acetabular fragment. The posterior column remains intact with a stable fixation of the acetabular fragment and a preserved shape of the true pelvis. There is a significant learning curve with severe complications in up to 30 % of cases. Good results can be expected in the long-term follow-up if performed with correct indication at young age in hips with preserved joint cartilage and proper reorientation of the acetabular fragment. Overall survivorship is superior to the natural course of hip dysplasia with a preserved hip joint in 61 % after 20 years.

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“…The original technique described by Ganz et al [6] used an iliofemoral exposure (modified Smith-Petersen [19]) involving extensive abductor dissection and transection of the indirect and direct heads of the rectus femoris tendon. Since the original description, there have been several reports describing different surgical approaches to perform a PAO.…”

Section: Introductionmentioning

confidence: 99%

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

Novais

Kim

Carry

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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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.

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Approach to and Exposure of the Hip Joint for Mold Arthroplasty

Cited by 268 publications

References 0 publications

Impingement Adversely Affects 10-year Survivorship After Periacetabular Osteotomy for DDH

Impingement Adversely Affects 10-year Survivorship After Periacetabular Osteotomy for DDH

Periacetabular osteotomy: a review of swiss experience

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

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