Chiari pelvic osteotomy in treatment of hip dysplasia

Abstract

Chiari pelvic osteotomy is a surgical procedure having been performed for almost sixty years in patients with the insufficient coverage of the femoral head. It is most frequently used in young patients with dysplastic acetabular sockets as a part of developmental hip dysplasia. Even though performance of the Chiari osteotomy is associated with positive therapeutical results, above all, its main goal is to delay inevitable degenerative changes. Original surgical technique has been modified and improved over time. Nevertheless, the basic idea has remained unchanged--increasing of the femoral head coverage by medial displacement of the distal partof the pelvis along with capsular interpositioning. Given the complexity of operation, the complication percentage is rather low. Chiari pelvic osteotomy has lost its actuality and importance during this past six decades. The role of Chiari pelvic osteotomy has been considerably taken over by other more efficient and more lasting surgical procedures. Nonetheless, Chiari pelvic osteotomy is still present in modern orthopedic practice, above all as,salvage" osteotomy.

Acetabular reaming and sartorius muscle pedicle iliac bone grafting in the treatment of developmental dysplasia of the hip in older children: A retrospective study of 15 patients with more than two years follow-up

“…This study also has the following limitations: 1) the study lacks a control group; 2) the cases were limited, and the follow-up time was relatively short; 3) whether the newly enlarged acetabulum has formed cartilage and whether the cartilage of the original acetabulum can heal with the acetabulum needs to be further proven; 4) the resulting development of the capsule between the increased bony tissue over the acetabulum and the femoral head has not been clearly studied. Previous studies 11,30,31 reported that the capsule between the increased bony tissue over the acetabulum and the femoral head may be transformed into atypical fibrous cartilage. However, pathology and animal experiments are needed to prove the specific mechanism.…”