期刊
INTERNATIONAL ORTHOPAEDICS
卷 -, 期 -, 页码 -出版社
SPRINGER
DOI: 10.1007/s00264-023-05912-9
关键词
Chiari pelvic osteotomy; Long-term follow-up; Developmental dysplasia of the hip; Hip arthroplasty
类别
The Chiari pelvic osteotomy is a surgical procedure that improves hip dysplasia by changing the position of the acetabulum. It has achieved excellent long-term results, especially in young patients without osteoarthritis.
PurposeThe Chiari pelvic osteotomy was the first surgical procedure to address hip dysplasia by changing the position of the acetabulum by medialization, thus creating a bony roof and improving biomechanical conditions. The aim of this retrospective cohort study was to report on the very long-term results of this technique.MethodsOut of a consecutive series of 1536 hips, 504 in 405 patients were available for follow-up. The patients were assessed by physical and radiological examination. A Kaplan-Meier survival analysis with total hip arthroplasty as an endpoint was performed and stratified for age groups, pre-operative diagnosis, sex and osteoarthritis stage.ResultsThe average follow-up was 36 & PLUSMN; 8.1 years (range, 35.2 to 54). The average pain level on the Visual Analogue Scale was 2.9 & PLUSMN; 2.6 (range 0 to 8.7). The average Harris Hip Score was 80.2 & PLUSMN; 17.4 (range 17.4 to 100). Correction of dysplasia was effective and remained stable over time. Osteoarthritis significantly increased over time with 53% Tonnis grade 3 at follow-up. The cumulative survivorship was 79.8% (95% confidence interval (CI), 76.1-83.2%) at 20 years, 57.1% (95% CI, 52.8-61.8%) at 30 years and 35% (95% CI, 30.3-40.3%) at 40 years. Young age, male sex and low osteoarthritis grade were positive prognostic factors.ConclusionsAlthough the Chiari pelvic osteotomy is considered a salvage procedure nowadays, it achieved excellent long-term results even in indications, which would be treated differently today. Young patients without osteoarthritis had the best outcome.
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