Birth after bernese periacetabular osteotomy

Fluckiger, G; Eggli, Stefan; Košina, Josef; Ganz, Reinhold

doi:10.1007/s001320050009

Cited by 16 publications

(11 citation statements)

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“…The acetabular fragment is easily fixed with cortical screws and early partial weight bearing is possible. The shape of the true pelvis is not altered and a vaginal birth is possible [23,25]. The PAO has reportedly led to good to excellent results with survivorship of the affected hip up to 61 % at 20 years [26•].…”

Section: Introductionmentioning

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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Section: Introductionmentioning

confidence: 99%

Periacetabular osteotomy: a review of swiss experience

Büchler

Beck

2014

Curr Rev Musculoskelet Med

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“…In the event of such an operation, the increased sphericity of the acetabulum after the osteotomy provides better fixation possibilities for the acetabular cup. Furthermore, Flückiger et al (2000) have shown that the diameter of the true pelvis after surgery permits unimpaired vaginal delivery. The improved pain and functions scores were also accompanied by patient satisfaction; 29 of 32 patients were definitely satisfied with the outcome.…”

Section: Discussionmentioning

confidence: 99%

“…This is a polygon-shaped juxtaarticular osteotomy ( Figure DOI 1) which may be performed through one single approach, where large corrections can be obtained in all directions without any external fixation since the posterior column of the ischium remains intact, protecting the sciatic nerve and permitting early mobilization. The diameter of the true pelvis remains intact, permitting unimpaired vaginal delivery (Flückiger et al 2000). The blood supply to the acetabulum is preserved and this allows an anterior joint capsulotomy for diagnosis and treatment of intra-articular diseases.…”

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confidence: 99%

Periacetabular osteotomy

2005

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Background When surgical treatment of dysplastic hip osteoarthrosis is necessary, osteotomy is preferable to fusion or THR. We evaluated periacetabular osteotomy as a method of choice.Patients and methods We treated 36 symptomatic dysplastic hip joints (32 patients) with the Bernese periacetabular osteotomy (PAO) between 1994 and 2001. We used the ilio-inguinal (I-I) approach in 32 hips and a modified Smith-Petersen (S-P) approach in 4. The patients were followed for mean 4 (1.5-8) years. In 1 patient with coxa valga, a varus femoral osteotomy was performed 1 year after PAO. 2 hips, in which we used the modified S-P approach, necessitated a capsulotomy.Results Major complications included 1 partial lesion of the sciatic nerve, 1 malunion and 1 combined nonunion of the pubic and ischiatic osteotomy. 2 patients underwent subsequent total hip replacement (THR) for progressive osteoarthrosis with pain.Interpretation We found good radiographic correction of deformities, improvement of hip function and pain relief with an acceptable complication rate. With appropriate patient selection, this procedure is the most

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“…A few studies with small numbers of patients and theoretical models have described the influence of pelvic osteotomies on pelvic morphology and the birth canal [ 32 , 38 , 41 ]. Those studies showed that pelvic osteotomies had no effect on the pelvic inlet, but caused narrowing of the pelvic outlet, particularly after the Salter, Sutherland, and Steel osteotomies.…”

Section: Classifications Of the Female Pelvis Based On Bone And Ligament Morphology And Their Relationships To Pelvic Osteotomymentioning

confidence: 99%

Current Evidence about Developmental Dysplasia of the Hip in Pregnancy

Simionescu

Cîrstoiu

et al. 2021

Medicina

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In adults, developmental dysplasia of the hip (DDH) represents a spectrum of disorders. It is commonly found in women in routine orthopedic practice. Hip dysplasia is a leading precursor of joint laxity; when untreated, it can contribute to chronic modifications, such as thickening of the pulvinar and ligamentum teres (which can also elongate), hypertrophy of the transverse acetabular ligament, and osteoarthritis. DDH is presumed to be associated with alterations in pelvic morphology that may affect vaginal birth by the reduction in the transverse diameter of the pelvic inlet or outlet. Here, we provide an overview of the current knowledge of pregnancy-associated DDH. We primarily focused on how a surgical DDH treatment might influence the pelvic shape and size and the effects on the mechanism of birth. We presented the female pelvis from the standpoint of bone and ligament morphology relative to a pelvic osteotomy. Then, we described whether the pregnancy was impacted by previous surgical DDH treatments, performed from infancy to adulthood. In conclusion, hip dysplasia is not associated with high-risk complications during pregnancy or with increased difficulty in vaginal delivery.

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Birth after bernese periacetabular osteotomy

Cited by 16 publications

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Periacetabular osteotomy: a review of swiss experience

Periacetabular osteotomy: a review of swiss experience

Periacetabular osteotomy

Current Evidence about Developmental Dysplasia of the Hip in Pregnancy

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