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PRELIMINARY RESULTS OF THE BERNESE PERIACETABULAR OSTEOTOMY AT AN U. K. DISTRICT HOSPITAL



Abstract

We present the early results of the Bernese osteotomy via an ilioinguinal approach performed at an U.K. district general hospital with no links to the Bernese group.

Between 1997 and 2002, 19 such osteotomies have been performed at our institution. Average follow-up is 3.2 years (range: 1–5.5 years). The male: female ratio was 1: 8.5. Average age at time of operation was 32.3 years (range 18 – 48). 14 were classified as having Severin grade 2 dysplasia and 5 as having Severin grade 3 dysplasia. The average preoperative Merle d’Aubigne and Postel score was 12.7 points (range 6 – 15). 21.1% of patients were rated as good, as 57.8% fair and 21.1% poor.

At most recent follow-up of preserved hip joints total mean score had increased to 16.3 (range 13 – 18). 26.3% of hips were graded as excellent, 58.9% as good and 14.8% as fair. The average postoperative values for the lateral centre-edge angle and acetabular index were 42.3° and 10.0° respectively which represents an average of 31.4° and 24.7° of improved lateral and loading zone coverage after osteotomy. The preoperative severity of osteoarthritis according to the criteria of Tonnis was grade 1 in 15.8% and grade 2 in 26.3%. Only one joint deteriorated sufficiently for it to be converted to a total hip arthroplasty. There was an overall complication rate of 59.9% comprised of 47.4% trivial, 10.4% moderate and 0.05% major complications. Our early results demonstrate the steep learning curve of this technically demanding operation and are encouraging.

Theses abstracts were prepared by Mr Peter Kay. Correspondence should be address to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.