How Often Does Femoroacetabular Impingement Occur After an Innominate Osteotomy for Acetabular Dysplasia?

Castañeda, Pablo; Vidal-Ruiz, Carlos; Méndez, Alfonso; Salazar, Diego Pérez; Torres, A. Lisón

doi:10.1007/s11999-016-4721-7

Cited by 22 publications

(11 citation statements)

References 33 publications

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“…Femoroacetabular impingement (FAI) after innominate osteotomy has been reported in some studies. Castaneda et al 22) reported the incidence as 12% (18 of 154 hips) among patients who had undergone Pemberton osteotomy and Salter osteotomy. FAI after innominate osteotomy was not common but the incidence was related to the angle of overcorrection in the study.…”

Section: Discussionmentioning

confidence: 99%

Long-term Results of Modified Salter Innominate Osteotomy for Legg-Calvé-Perthes Disease

et al. 2017

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BackgroundIn a previous study, we reported clinical and radiographic results of our modified Salter innominate osteotomy technique in 16 hips affected by Legg-Calvé-Perthes disease (LCPD) with an average follow-up of 31.8 months. In this study, we present the long-term results of the osteotomy in LCPD patients followed until physeal closure.MethodsThirty hips of 29 patients were followed until skeletal maturation after modified Salter innominate osteotomy. The mean follow-up duration was 12.9 years (range, 9.1 to 16.0 years). Eleven hips (36.7%) were classified as Catterall group III and 19 (63.3%) as Catterall group VI. Stable interposition of a bone block was achieved using one biodegradable screw in nine hips and without any fixation device in 21 hips by simply changing the direction of osteotomy. The Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and hip function were evaluated at the last follow-up. Radiological outcomes were evaluated using Wiberg's center-edge angle, the Mose method, and Stulberg classification, and osteoarthritic changes were evaluated using the Tonnis classification.ResultsMean HHS and WOMAC score were 80.2 points and 54 points, respectively, preoperatively and these were improved to 96.2 points and 28 points, respectively, at the last follow-up. Clinical results, according to Robinson's criteria, were good in 18, fair in seven, and poor in five hips. Radiological results assessed using the Mose method were good in 18, fair in six, and poor in six hips, and according to the Stulberg classification, nine hips were class I, nine were class II, eight were class III, and four were class IV. The mean center-edge angle improved from 19.7° preoperatively to 29.6° at the final follow-up. According the Tonnis classification, three hips were grade 2, five were grade 1, and 22 were grade 0. Of the three grade 2 hips, two underwent Chiari osteotomy 12.1 and 8.8 years postoperatively, and the other underwent total hip arthroplasty 12.9 years postoperatively.ConclusionsThe modified Salter innominate osteotomy produced relatively satisfactory long-term clinical and radiological results.

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Section: Discussionmentioning

confidence: 99%

Long-term Results of Modified Salter Innominate Osteotomy for Legg-Calvé-Perthes Disease

et al. 2017

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“…анализ рентгенометрических показателей показал, что у 46,7% пациентов контрольной группы имелась гиперкоррекции пространственного положения вертлужной впадины. Конечным исходом такой рентгенологической ситуации, как правило, является формирование pincer-типа фемороацетабулярного импинджмента с соответствующими клиническими проявлениями [26,32,36]. Кроме того, у 6,7% пациентов контрольной группы отмечалась недостаточная коррекция положения вертлужной впадины, что не обеспечило надлежащей степени костного покрытия головки бедренной кости и не способствовало перераспределению нагрузки на суставные поверхности головки бедренной кости и вертлужной впадины.…”

Section: результатыunclassified

“…на сегодняшний день в литературе имеется большое количество публикаций, касающихся хирургического лечения детей с различной степенью тяжести дисплазии тазобедренных суставов посредством выполнения реориентирующих остеотомий таза [28][29][30]. Появились исследования, указывающие на формирование гиперкоррекции пространственного положения тазового компонента в результате этих хирургических вмешательств [31][32][33][34]. Однако необходимо подчеркнуть, что эти работы носят достаточно противоречивый характер с точки зрения оценки этой гиперкоррекции как с клинической стороны, так и на основании данных лучевого исследования.…”

Section: результатыunclassified

“…Однако одним из выводов этой публикации является необходимость тщательного предоперационного планирования с целью обеспечения минимального процента гиперкоррекции при подобных операциях. Ряд других исследователей утверждает, что избыточная коррекция положения вертлужной впадины, особенно кпереди, приводит к значимому снижению амплитуды движений в тазобедренном суставе, сохраняющемуся болевому синдрому и, как следствие, неудовлетворенности пациента столь травматичным хирургическим вмешательством [32][33][34]. Все это подчеркивает необходимость поиска решений для осуществления максимально точной индивидуальной многоплоскостной коррекции пространственного положения вертлужной впадины в ходе выполнения реоринетирующей остеотомии таза для исключения возникновения как ранних, так и поздних послеоперационных осложнений.…”

Section: результатыunclassified

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Patient-Specific Templates for Triple Pelvic Osteotomy in Children with Dysplastic Hip Subluxation (Preliminary Results)

Бортулёв

Vissarionov

Baskov

et al. 2019

Traumatology and Orthopedics of Russia

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Purpose of the study — to evaluate the degree of correction of acetabular spatial position after triple pelvic osteotomy using patient-specific templates in children with dysplastic hip subluxation. Materials and methods. Study included 30 patients (30 hips) with dysplastic hip subluxation aging from 14 to 18 years (mean age of 16.3±1.4). All children were divided into two groups — main group consisted of 15 children (15 hips) who underwent triple pelvic osteotomy using patient-specific templates produced by 3D modeling and prototyping technology; control group consisted of 15 children (15 hips) who underwent triple pelvic osteotomy based on standard preoperative planning. X-ray and CT of hip joints was made in all patients. Results. Parameters of acetabular spatial position as well as integral parameters which define the ratio between acetabulum and femoral components and hip stability were in the range of normal variation in patients of the main group. Similar average parameters in patients of control group were below the lower margin of the physiological norm (p<0.05). Besides, the values of standard deviation of abovementioned X-ray parameters in some patients of control group demonstrated pronounced variability characterized by hyper- and hypo-correction values of spatial position of acetabular fragment. Conclusion. In contrast to standard preoperative planning the use of patient-specific templates during re-orienting triple pelvic osteotomy in children with dysplastic hip subluxation allows to level out possible errors in three-dimensional acetabulum positioning towards hyper- and hypo-correction (p<0.05) of pelvic component. This creates conditions to ensure adequate hip stability which is confirmed by key x-ray indices with values within normal reference range.

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“…Moreover, it is paramount to diagnose retroversion in those hips in order to be able to correctly orient the osteotomized fragment and thus avoid postoperative impingement. Because when corrected, those hips becoming normally covered but still retroverted, will have the distance of the anterior wall to the head-neck junction shortened, and hence will become symptomatic [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy

El-Hajj

Abdelnour

Ayoubi

et al. 2020

Advances in Orthopedics

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Purpose. Radiological diagnosis of acetabular retroversion (AR) is based on the presence of the crossover sign (COS), the posterior wall sign (PWS), and the prominence of the ischial spine sign (PRISS). The primary purpose of the study is to analyze the clinical significance of the PRISS in a sample of dysplastic hips requiring periacetabular osteotomy (PAO) and evaluate retroversion in symptomatic hip dysplasia. Methods. In a previous paper, we reported the classic coxometric measurements of 178 patients with symptomatic hip dysplasia undergoing PAO where retroversion was noted in 42% of the cases and was not found to be a major factor in the appearance of symptoms. In the current study, we have added the retroversion signs PRISS and PWS to our analysis. Among the retroverted dysplastic hips, we studied the association of the PRISS with the hips requiring PAO. We also defined the ischial spine index (ISI) and studied its relationship to the coxometric measurements and AR. Results. In hips with AR, the operated hips were significantly associated with the PRISS compared to the nonoperated ones (χ2 = 4.847). Additionally, the ISI was able to classify acetabular version (anteverted, neutral, and retroverted acetabula). A direct correlation between the ISI and the retroversion index (RI) was found, and the highest degree of retroversion was found when the 3 signs of acetabular retroversion were concomitantly present (RI = 33.6%). Conclusion. The PRISS, a radiographic sign reflecting AR, was found to be significantly associated with dysplastic hips requiring PAO where AR was previously not considered a factor in the manifestation of symptoms and subsequent requirement for surgery. Moreover, the PRISS can also serve as an adequate radiographic sign for estimating acetabular version on pelvic radiographs.

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How Often Does Femoroacetabular Impingement Occur After an Innominate Osteotomy for Acetabular Dysplasia?

Cited by 22 publications

References 33 publications

Long-term Results of Modified Salter Innominate Osteotomy for Legg-Calvé-Perthes Disease

Long-term Results of Modified Salter Innominate Osteotomy for Legg-Calvé-Perthes Disease

Patient-Specific Templates for Triple Pelvic Osteotomy in Children with Dysplastic Hip Subluxation (Preliminary Results)

The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy

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