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Joint congruency in abduction before surgery as an indication for rotational acetabular osteotomy in early hip osteoarthritis

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Abstract

We conducted a retrospective review of the results of rotational acetabular osteotomy (RAO) procedures in 92 hips of 89 patients (81 females and eight males) with early-stage osteoarthritis. In this study, we discuss the indications for this surgery based on the preoperative congruency in abduction. The mean postoperative follow-up was 12.2 (7–19) years. The mean age at operation was 32.5 (13–54) years. Two hips with apparent technical failure were excluded. During follow-up, the osteoarthritic stage remained unchanged in 76 hips (good group) and progressed in 14 hips (poor group). Preoperative joint congruency in abduction was excellent in 20 hips, good in 62, and fair in eight. All eight hips with fair joint congruency showed progression to osteoarthritis at follow-up. Patients without good congruency in abduction may experience progression of osteoarthritis after RAO procedures even in early-stage osteoarthritis.

Resumé

Nous avons réalisé une étude rétrospective des résultats de l’ostéotomie acétabulaire (RAO) sur 92 hanches chez 89 patients (81 femmes et 8 hommes). Ces patients présentaient une arthrose précoce de hanche. Nous avons discuté dans cette étude les indications de la chirurgie basée notamment sur la congruence préopératoire en abduction de l’articulation. Le suivi moyen postopératoire a été de 12,2 ans (de 7 à 19 ans). L’âge moyen d’intervention de 32,5 ans (de 13 à 54 ans). 2 hanches présentaient un défaut technique et ont été exclues de l’étude. Durant le suivi, l’arthrose n’a pas évolué sur 76 hanches (groupe bon) et a progressé dans 14 hanches (groupe mauvais). La congruence préopératoire de l’articulation de la hanche en abduction était excellente dans 20 hanches, bonne dans 62 et médiocre dans 8 hanches. Les 8 hanches présentant une congruence médiocre ont montré en préopératoire une progression de l’arthrose tout au long du suivi. En conclusion, les patients avec une bonne congruence en abduction ont profité de l’ostéotomie de rotation acétabulaire y compris quand il existe une arthrose précoce.

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References

  1. Chiari K (1974) Medial displacement osteotomy of the pelvis. Clin Orthop Relat Res 98:55–71

    Article  PubMed  Google Scholar 

  2. Clohisy JC, Nunley RM, Curry MC, Schoenecker PL (2007) Periacetabular osteotomy for the treatment of acetabular dysplasia associated with major aspherical femoral head deformities. J Bone Joint Surg Am 89:1417–1423

    Article  PubMed  Google Scholar 

  3. Eppright RH (1975) Dial osteotomy of the acetabulum in the treatment of dysplasia of the hip. J Bone Joint Surg Am 57–A:1172

  4. Fawzy E, Mandellos G, De Steiger R et al (2005) Is there a place for shelf acetabuloplasty in the management of adult acetabular dysplasia? A survivorship study. J Bone Joint Surg Br 87:1197–1202

    Article  CAS  PubMed  Google Scholar 

  5. Ganz R, Klaue K, Vinh TS, Mast JW (1988) A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res 232:26–36

    PubMed  Google Scholar 

  6. Hasegawa Y, Iwata H, Mizuno M, Genda E, Sato S, Miura T (1992) The natural course of osteoarthritis of the hip due to subluxation or acetabular dysplasia. Arch Orthop Trauma Surg 111:187–191

    Article  CAS  PubMed  Google Scholar 

  7. Hasegawa Y, Masui T, Yamaguchi J, Kawabe K, Suzuki S (2007) Factors leading to osteoarthritis after eccentric rotational acetabular osteotomy. Clin Orthop Relat Res 459:207–215

    Article  PubMed  Google Scholar 

  8. Heyman CH, Herndon CH (1950) Legg-Perthes disease. A method for the measurement of the rentogenographic result. J Bone Joint Surg Am 32:767–768

    CAS  PubMed  Google Scholar 

  9. Hoaglund FT, Shiba R, Newberg AH, Leung KY (1985) Diseases of the hip. A comparative study of Japanese Oriental and American white patients. J Bone Joint Surg Am 67:1376–1383

    CAS  PubMed  Google Scholar 

  10. Ito H, Matsuno T, Minami A (2005) Intertrochanteric varus osteotomy for osteoarthritis in patients with hip dysplasia: 6 to 28 years followup. Clin Orthop Relat Res 433:124–128

    Article  PubMed  Google Scholar 

  11. Koulouvaris P, Stafylas K, Aznaoutoglou C et al (2007) Isolated varus intertrochanteric osteotomy for hip dysplasia in 52 patients: long-term results. Int Orthop 31:193–198

    Article  CAS  PubMed  Google Scholar 

  12. Matsui M, Masuhara K, Nakata K, Nishii T, Sugano N, Ochi T (1997) Early deterioration after modified rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Br 79:220–224

    Article  CAS  PubMed  Google Scholar 

  13. Mayo KA, Trumble SJ, Mast JW (1999) Results of periacetabular osteotomy in patients with previous surgery for hip dysplasia. Clin Orthop Relat Res 363:73–80

    Article  PubMed  Google Scholar 

  14. Merle d’Aubigne R, Postel M (1954) Function al results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36:451–475

    Google Scholar 

  15. Nakamura S, Ninomiya S, Nakamura T (1989) Primary osteoarthritis of the hip joint in Japan. Clin Orthop Relat Res 241:190–196

    PubMed  Google Scholar 

  16. Nakamura S, Ninomiya S, Takatori Y, Morimoto S, Umeyama T (1998) Long-term outcome of rotational acetabular osteotomy: 145 hips followed for 10–23 years. Acta Orthop Scand 69:259–265

    Article  CAS  PubMed  Google Scholar 

  17. Ninomiya S, Tagawa H (1984) Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Am 66:430–436

    CAS  PubMed  Google Scholar 

  18. Nozawa M, Shitoto K, Matsuda K, Maezawa K, Kurosawa H (2002) Rotational acetabular osteotomy for acetabular dysplasia. A follow-up for more than ten years. J Bone Joint Surg Br 84:59–65

    Article  PubMed  Google Scholar 

  19. Okano K, Enomoto H, Osaki M, Shindo H (2008) Outcome of rotational acetabular osteotomy for early hip osteoarthritis secondary to dysplasia related to femoral head shape: 49 hips followed for 10–17 years. Acta Orthop 79:12–7

    Article  PubMed  Google Scholar 

  20. Okano K, Enomoto H, Osaki M, Shindo H (2008) Rotational acetabular osteotomy with a resection of the lateral edge of the acetabulum for the treatment of advanced coxarthrosis. Arch Orthop Trauma Surg 128:393–7

    Article  CAS  PubMed  Google Scholar 

  21. Rosen SV (1962) Diagnosis and treatment of congenital dislocation of the hip joint in the new-born. J Bone Joint Surg Br 44:284–291

    Google Scholar 

  22. Schramm M, Pitto RP, Bar K, Meyer M, Rohm E, Hohmann D (1999) Prophylaxis of secondary osteoarthrosis with spherical osteotomy in residual acetabular dysplasia: analysis of predictive factors of success. Arch Orthop Trauma Surg 119:418–422

    Article  CAS  PubMed  Google Scholar 

  23. Sharp IK (1961) Acetabular dysplasia: the acetabular angle. J Bone Joint Surg Br 43:268–272

    Google Scholar 

  24. Siebenrock KA, Scholl E, Lottenbach M, Ganz R (1999) Bernese periacetabular osteotomy. Clin Orthop Relat Res 363:9–20

    Article  PubMed  Google Scholar 

  25. Steel HH (1973) Triple osteotomy of the innominate bone. J Bone Joint Surg Am 55:343–350

    CAS  PubMed  Google Scholar 

  26. Takatori Y, Ninomiya S, Nakamura S, Morimoto S, Moro T, Nagai I, Mabuchi A (2001) Long-term results of rotational acetabular osteotomy in patients with slight narrowing of the joint space on preoperative radiographic findings. J Orthop Sci 6:137–140

    Article  CAS  PubMed  Google Scholar 

  27. Trousdale RT, Cabanela ME (2003) Lessons learned after more than 250 periacetabular osteotomies. Acta Orthop Scand 74:119–126

    Article  PubMed  Google Scholar 

  28. Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL (1995) Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am 77:73–85

    CAS  PubMed  Google Scholar 

  29. Wiberg G (1939) Studies on dysplastic acetabula and congenital subluxation of the hip joint. With special reference to the complication of osteoarthritis. Acta Chir Scand 58:28–38

    Google Scholar 

  30. Yanagimoto S, Hotta H, Izumida R, Sakamaki T (2005) Long-term results of Chiari pelvic osteotomy in patients with developmental dysplasia of the hip: indications for Chiari pelvic osteotomy according to disease stage and femoral head shape. J Orthop Sci 10:557–563

    Article  PubMed  Google Scholar 

  31. Yasunaga Y, Hisatome T, Tanaka R et al (2005) Curved varus femoral osteotomy for minimal dysplastic hip in patients older than 45 years of age: comparison with rotational acetabular osteotomy. J Orthop Sci 10:264–269

    Article  CAS  PubMed  Google Scholar 

  32. Yasunaga Y, Ikuta Y, Kanazawa T, Takahashi K, Hisatome T (2001) The state of the articular cartilage at the time of surgery as an indication for rotational acetabular osteotomy. J Bone Joint Surg Br 83:1001–1004

    Article  CAS  PubMed  Google Scholar 

  33. Yasunaga Y, Takahashi K, Ochi M, Ikuta Y, Hisatome T, Nakashiro J, Yamamoto S (2003) Rotational acetabular osteotomy in patients forty-six years of age or older: comparison with younger patients. J Bone Joint Surg Am 85:266–272

    PubMed  Google Scholar 

  34. Yoshimura N, Campbell L, Hashimoto T, Kinoshita H, Okayasu T, Wilman C, Coggon D, Croft P, Cooper C (1998) Acetabular dysplasia and hip osteoarthritis in Britain and Japan. Br J Rheumatol 37:1193–1197

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank Dr. Katsuro Iwasaki for assistance and advice concerning rotational acetabular osteotomy.

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Correspondence to Kunihiko Okano.

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No benefits in any form have been received or will be received from a commercial party related directly to the subject of this article.

The study did not receive institutional review board approval because our institution does not require such approval for therapeutic studies.

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Okano, K., Yamada, K., Takahashi, K. et al. Joint congruency in abduction before surgery as an indication for rotational acetabular osteotomy in early hip osteoarthritis. International Orthopaedics (SICOT) 34, 27–32 (2010). https://doi.org/10.1007/s00264-009-0734-0

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  • DOI: https://doi.org/10.1007/s00264-009-0734-0

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