Abstract
Introduction
Pelvic osteotomy such as Chiari osteotomy and rotational acetabular osteotomy (RAO) have been used successfully in patients with developmental dysplasia of the hip (DDH). However, some patients are forced to undergo total hip arthroplasty (THA) because of the progression of osteoarthritis. THA after pelvic osteotomy is thought to be more difficult because of altered anatomy of the pelvis. We compared six THAs done in dysplastic hips after previous pelvic osteotomy between 2008 and 2015 with a well-matched control group of 20 primary procedures done during the same period.
Materials and methods
Six THAs for DDH after previous Pelvic osteotomy (three Chiari osteotomies and three RAOs) were compared with 20 THAs for DDH without previous surgery. The patients were matched for age, sex, and BMI. Minimum follow-up for both groups of patients was one year (range, 12–79 months and 12–77 months, respectively). The average interval from pelvic osteotomy to total hip arthroplasty was 19.8 years (range 12–26 years). Clinical and Radiological evaluations were performed.
Results
Both groups had similar short-term results except clinical score. There were no signiï¬ï¿½cant differences in range of motion, intraoperative blood loss and operative time between the two groups. There were no infections, dislocations, intraoperative fractures, damaged nerves, or deep vein thromboses in either group. Clinical score according to Japanese Orthopaedic Association rating system at the most recent follow-up were significantly lower in previous pelvic osteotomy group (P=0.003). Lower clinical score was assumed to be caused by one patient with previous Chiari osteotomy who had contralateral sciatic nerve palsy which was unrelated to the surgery.
Although we were concerned about the failures on the acetabular side in patients with THA after pelvic osteotomy because of osteosclerotic acetabular bone, no acetabular component exhibited loosening or revision. This result supports the thought that the pelvic osteotomy fragment maintains its blood supply and allows porous acetabular components to ingrow.
Conclusion
Pelvic osteotomies do not seem to compromise the short-term clinical or radiographic outcome
