Salter innominate osteotomy in the treatment of late presentation Perthes disease

Yavuz, Umut; Demir, Bilal; Yıldırım, Timur; Beng, Kubilay; Karakas, Eyup Salahattin

doi:10.5301/hipint.5000086

Cited by 4 publications

(8 citation statements)

References 26 publications

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“…Four articles looked at FVO [ 17 , 18 , 19 , 22 ], two articles evaluated the combination of FVO + Salter osteotomy [ 23 , 26 ], eight articles examined lateral shelf acetabuloplasty [ 20 , 24 , 27 , 28 , 29 , 33 , 36 , 37 ], two articles addressed arthrodiastasis [ 25 , 30 ], tow articles analyzed the Salter osteotomy [ 34 , 39 ], and two articles described the rotational transtrochanteric osteotomy [ 31 , 32 ]. Finally, one article analyzed the Chiari osteotomy [ 21 ], one the triple osteotomy [ 38 ], and one the combination of shelf acetabuloplasty + FVO [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Mid–Long-Term Outcomes of Surgical Treatment of Legg-Calvè-Perthes Disease: A Systematic Review

et al. 2022

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Background: Legg–Calvè–Perthes disease (LCPD) is a common childhood disease that usually occurs in 4- to 12-year-old children. Surgical treatment consists of femoral, pelvic, or combined osteotomies. This comprehensive review aimed to investigate the mid- and long-term outcome of the surgical treatment. Methods: A systematic review of PubMed, Science Direct, and MEDLINE databases was performed by two independent authors, using the keywords “outcome”, “surgical treatment”, “pelvic osteotomy”, “femoral osteotomy”, and “Legg–Calvè–Perthes disease” to evaluate studies of any level of evidence that reported the surgical outcome of LCPD. The result of every stage was reviewed and approved by two senior investigators. Results: A total of 2153 articles were found. At the end of the screening, we selected 23 articles eligible for full-text reading according to the inclusion and exclusion criteria. Our analysis showed that the main prognostic factors for surgical outcome in patients with LCPD are the age at onset and the degree of initial disease severity. Conclusions: Surgical treatment in patients older than 6 years has excellent results in Herring B and B/C hips and poor results in Herring C hips, with a slight advantage for patients between 6 and 8 years old.

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Section: Resultsmentioning

confidence: 99%

Mid–Long-Term Outcomes of Surgical Treatment of Legg-Calvè-Perthes Disease: A Systematic Review

et al. 2022

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“…Innominate osteotomy can alter the natural process of LCPD and benefit femoral head remodeling during remaining growth. [3] Park et al and Yavuz et al [16,17] also indicated that Salter osteotomy could improve the sphericity of the femoral head. Salter osteotomy is an effective method of surgical treatment for LCPD in patients younger than 8 years.…”

Section: Discussionmentioning

confidence: 99%

Lateral shelf acetabuloplasty for severe Legg–Calvé–Perthes disease in patients older than 8 years

Ren

2016

Medicine

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The natural history of Legg–Calvé–Perthes disease (LCPD) in children older than 8 years is usually poor without treatment. The treatment goal is to prevent deformity and incongruity of the hip by achieving a stable spherical femoral head in a deep, congruent, sharp-edged acetabulum, with a good range of hip movement at skeletal maturity. Lateral shelf acetabuloplasty in LCPD can increase the coverage of the femoral head, benefiting the remodeling of the femoral head and acetabulum. The aim of this study was to evaluate the efficacy of lateral shelf acetabuloplasty for severe LCPD in patients older than 8 years.We evaluated 51 patients with severe LCPD who underwent shelf acetabuloplasty between 1994 and 2005. Clinical and radiological examinations were evaluated preoperatively and over a mean follow-up of 132.35 months (range 102–183 months). According to the Catterall classification, the LCPD was classified as grade II in 11 (21.6%) patients, grade III in 15 (29.4%), and grade IV in 25 (49.0%). According to the Herring classification, there were 12 (23.5%) patients in grade B, 24 (47.1%) in grade B/C, and 15 (29.4%) in grade C. The mean ages at the onset of signs and at surgery were 103.39 months and 110.78 months, respectively.By the end of follow-up, all patients had a normal passive range of hip movement without pain. The mean Iowa hip score was improved from 69.5 ± 7.28 to 91.6 ± 5.14 (P < 0.001). According to the Stulberg classification, 11 (21.6%) hips were classified as grade 1, 19 (37.3%) hips as grade 2, 14 (27.5%) hips as grade 3, and 7 (13.7%) hips as grade 4. The CE angle, Sharp angle, medial joint space ratio, epiphysis height ratio, and percentage of acetabular coverage were significantly improved by shelf acetabuloplasty (P < 0.001).We recommend shelf acetabuloplasty for severe LCPD in patients older than 8 years. The procedure yields a favorable clinical outcome and Stulberg outcome for the hip. Shelf acetabuloplasty can improve femoral head coverage and reduce subluxation of the hip, with a benefit to the biological remodeling of the femoral head within the acetabulum.

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“…Radiological evaluations were obtained preoperatively from the lateral pillar and the Catterall classification and from the Stulberg classification during the follow-up period (4,11,12) . The treatment at different stages demonstrated different results: stage 1 or 2, good; stage 3, fair; and stage 4 or 5, poor (1) . The mean Harris hip score was categorized as excellent (90 -100), good (80 -89), fair (70 -79) and poor (<70).…”

Section: Outcome Measuresmentioning

confidence: 98%

“…

Legg-Calve-Perthes disease (LCPD) is a childhood and juvenile hip disease of unknown etiology which causes interruption in the blood supply, and eventually leads to avascular necrosis of the femoral head (1) . Subsequently, it may cause

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confidence: 99%

Age and Factors Associated with Clinical and Radiological Outcomes of Surgical Containment in Legg-Calve-Perthes Disease

2022

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Purpose: To determine the factors associated with clinical and radiological outcomes in patients with Legg-Calve-Perthes disease (LCPD) treated with containment methods. Methods: This retrospective cohort study was conducted from 2007 – 2017. Patients diagnosed with LCPD in the fragmentation stage and treated using surgical containment methods were included. Study factors were age at diagnosis, preoperative radiographs analyzed for lateral pillar staging and Catterall classification. Outcome measurements were final follow-up radiograph, classified using modified Stulberg grading, and final clinical outcome, classified by Harris Hip Score. Results: We analyzed 44 hips. The average age of subjects during diagnosis and follow-up was 8.1 and 12.7 years, respectively. The average length of follow-up was 58.6 months. Nineteen hips were evaluated as “good” (Stulberg I or II), 22 hips as “fair” (Stulberg III), and four hips as “poor” (Stulberg IV); no hips were classified as Stulberg V. Although not significant, the combination of Salter osteotomy and femoral varus osteotomy yielded better outcomes than varus osteotomy alone in the group >8 years old (p=0.247). The median age of 7 (7 – 8) years old was correlated with “good to excellent” Harris Hip Score while median age of 9 years was significantly correlated with the score of “fair” and “poor” (p=0.018). Lateral pillar A and B yielded significantly better results than lateral pillar C (p=0.014). Conclusion: The containment methods demonstrated favorable outcomes when treating patients < 9 years. Lateral pillars A and B had good end results. Combined pelvic and femoral osteotomy can improve radiographic and clinical outcomes.

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Salter innominate osteotomy in the treatment of late presentation Perthes disease

Abstract: Salter osteotomy can be used to treat older patients with lateral pillar stage B, B/C and C at presentation.

Cited by 4 publications

References 26 publications

Mid–Long-Term Outcomes of Surgical Treatment of Legg-Calvè-Perthes Disease: A Systematic Review

Mid–Long-Term Outcomes of Surgical Treatment of Legg-Calvè-Perthes Disease: A Systematic Review

Lateral shelf acetabuloplasty for severe Legg–Calvé–Perthes disease in patients older than 8 years

Age and Factors Associated with Clinical and Radiological Outcomes of Surgical Containment in Legg-Calve-Perthes Disease

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