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At least 19 recordsLinked to original sources
PubMed2003

Teardrop-femoral head distance after shelf acetabuloplasty for Perthes' disease.

Shelf acetabuloplasty is an accepted treatment for Perthes' disease. Favourable outcomes have been reported. This study aimed at determining whether changes in femoral head subluxation after shelf acetabuloplasty occur and whether they predict outcome. We assumed that reduction of subluxation after shelf acetabuloplasty would improve the long-term outcome. During follow-up, growth presented as a source of error when comparing the amount of absolute subluxation. Correction for growth was achieved by calculating a subluxation index. This index showed a significant reduction during follow-up. There was no correlation between clinical and radiological outcome, but the fact that the subluxation index showed a decreasing trend could be promising regarding outcome. This might be one of the reasons why shelf acetabuloplasty produces its effect. Following shelf acetabuloplasty the enlarged acetabulum could possibly direct the growth of the femoral head to a better-contained joint. This could result in better joint congruity and lesser tendency to degenerative arthritis.

Acetabulum↗
PubMedDate not supplied

[Growth disorders of the acetabular roof after acetabuloplasty in congenital hip dysplasia].

PURPOSE: The aim of this long-term study was to evaluate whether the Lance acetabuloplasty for congenital dysplasia of the hip causes a growth disturbance of the acetabular roof during or after puberty. METHOD: 71 hips of 58 patients were followed clinically and radiologically over a maximum time of 16 years after the operative procedure of a Lance acetabuloplasty. The average age of the patients at the time of operation was 2.8 years (1-6 years). In order to assess the growth of the acetabulum in the early and long-term postoperative phase quantitative parameters (acetabular index of Hilgenreiner, CE angle of Wiberg, ACM angle of Idelberger) as well as qualitative parameters (disturbance of the ossification of the acetabulum and the femoral head) were determined in standardized X-rays of the pelvis, done routinely 6 months, 3 years, 5 years, 8 years and at an average of 11 years as the last follow-up examination after the operation. The assessment of these metrical parameters were carried out in accordance to the classification of the study-group "hip dysplasia" of the DGOT (normal--slight pathological--serious pathological) respecting the different age-groups and degrees of dysplasia. RESULTS: Although in the early postoperative phase the acetabular roof showed a positive development (65% of the CE angles could be considered normal 3 years after operation), the further growth of the acetabulum was disturbed in the period of puberty (8 years after operation only 33% of the CE angles could be considered normal, 51% were extremely pathological). And also in the last X-ray control after an average follow-up time of 11 years a significant retardation of the acetabular roof was seen in 51% of all cases. CONCLUSION: The Lance acetabuloplasty seems to damage the Ossa acetabuli, which are as centers of ossification the essential anatomic structures for the growth of the acetabular rim in adolescence. CLINICAL RELEVANCE: Other procedures such as the Salter osteotomy are to be preferred for the therapy of hip dysplasia.

Acetabulum↗
PubMed1980

[Follow-up results of Dega's acetabuloplasty (author's transl)].

From 1966 to 1974 231 acetabuloplasties were performed in 193 children. Dega's technique was not consequently observed in these operations. The follow-up was made in 166 children with 202 acetabuloplasties. 65 per cent of the operated hips were found within the normal range. The clinical examination revealed excellent and good results in 82 per cent. There was a relatively great number of failures due to technical problems, mainly in the first time. The results obtained allow the conclusion that Dega's acetabuloplasty is a valuable method in the operative treatment of the congenital hip in early childhood provided that it is performed with a good operative technique. Because of the possible failures we prefer now Pemberton's pericapsular osteotomy of the ilium.

Acetabulum↗
PubMed2002

Comparison between Salter's innominate osteotomy and augmented acetabuloplasty in the treatment of patients with severe Legg-Calvé-Perthes disease. Analysis of 90 hips with special reference to roentgenographic sphericity and coverage of the femoral head.

This is a roentgenographic and retrospective study comparing the results of two different operative procedures used in the treatment of Legg-Calvé-Perthes disease: Salter innominate osteotomy, and Augmented Acetabuloplasty. Group I comprised 43 patients (50 hips) who underwent Salter osteotomy. Another 40 patients (40 hips) were treated by Augmented Acetabuloplasty and formed Group 2. In Group 1, 11 (25.58%) patients were girls and 32 (74.42%) were boys. In Group 2, there were 4 (10%) girl and 36 (90%) boy patients. The average age was 6.62 years in Group 1 and 6.35 years in Group 2. Follow-up varied from 2 years to 10 years in both Groups 1 and 2. In Group 1, 18 (36%) hips were in the stage of necrosis, 28 (56%) in fragmentation, and 4 (8%) in reossification; in Group 2, 16 (40%) hips were in necrosis, 23 (57.5%) in fragmentation, and only 1 (2.5%) in reossification. All hips in necrosis were included in Salter and Thompson group B; all hips in fragmentation were classed as Catterall group 3 or 4. Preoperative arthrographs of the 50 hips in Group I were graded according to Laredo: 29 (58%) in group III, 18 (36%) in group IV, and 3 (6%) in group V. Only 23 of the 43 hips of Group 2 had preoperative arthrographs; there were 14 (60.87%) in group III, 8 (34.78%) in group IV, and 1 (4.35%) in group V. The preoperative Wiberg's Center-Edge (CE) angle of Group 2 (19.4 degrees) was significantly greater than that of Group 1 (16.7 degrees). The percentage difference (A%) between immediate postoperative and preoperative CE angle was significantly greater in Group 2. The delta% between final and immediate postoperative CE angle was significantly greater in Group 1, and within Group 1 it was significantly greater at age 4 years to 6 years. The A% between final and preoperative CE angle was statistically the same in both Group I and Group 2. The distribution of good, fair and poor Mose ratings did not differ in Group 1 and Group 2, but there was a tendency of better results after Augmented Acetabuloplasty in children older than 6 years. Younger patients of Group 1 (4-6 years) ended up with good results at a significantly higher frequency than the older ones. Group 1 children with preoperative Laredo III arthrography had good results in a significantly greater number of cases, as compared with Laredo grade IV. The delta% between final and immediate postoperative CE angle was greater in those hips with good Mose rating.

Acetabulum↗
PubMedDate not supplied

One-stage correction of the dysplastic hip in cerebral palsy with the San Diego acetabuloplasty: results and complications in 104 hips.

Ninety-two patients with cerebral palsy underwent a special type of pericapsular acetabuloplasty designed to correct the hip dysplasia that occurs in cerebral palsy. The osteotomy was performed as part of a combined procedure (including femoral osteotomy and soft-tissue releases). Retrospective analysis was performed on 75 of the children (104 hips from 1982 through 1995) with a mean follow-up of 6.9 years. Ninety-nine (95%) of the 104 hips remained well reduced at follow-up. There were no redislocations. If the preoperative migration percentage was >70% (severe subluxation), improved results were noted in hips that had an open reduction with capsulorrhaphy. There were 13 complications including intraarticular extension of the acetabuloplasty (one) and avascular necrosis of the femoral head (eight hips, 8%). Indications for addition of a pericapsular acetabuloplasty include an open triradiate cartilage, acetabular dysplasia (acetabular index >25 degrees), and subluxation or dislocation with a migration percentage of >40%. Even hips with relative incongruity and some deformity of the femoral head can be successfully treated with this combined approach.

Acetabulum↗
PubMed1991

[Long-term results of the Collona acetabuloplasty].

The authors evaluate in their paper the long-term results of capsular acetabuloplasty by Colonna's method in the material of the First Orthopaedic Clinic, Faculty Hospital Bratislava. The mean time interval after operation was 20 years. The results are compared with previous evaluations made by Cervenanský and Kalman. Very favourable results were recorded in 3% of the patients, good results in 24%, satisfactory results in 39% and poor results in 39% and poor results in 34% of the patients. A marked shift towards unsatisfactory results is due to incorrect indication of acetabuloplasty which in the was a certain compromise, and also due to the surgical technique. The authors assume that correct and early prevention and treatment will eliminate capsular acetabuloplasty from the range of standard surgical therapeutic procedures in L.c.c.

Acetabulum↗
PubMedDate not supplied

Premature closure of the triradiate cartilage: a potential complication of pericapsular acetabuloplasty.

A case of premature triradiate cartilage closure secondary to a Gill acetabuloplasty performed at age 14 months is reported. The deficiency in acetabular development and failure of the pelvis to grow to its anticipated height is documented. A proximal femoral redirectional osteotomy and an innominate osteotomy performed near maturity improved femoral head coverage and hip biomechanics. Acetabuloplasties performed adjacent to the triradiate cartilage typically do not have any adverse effect on its function. Despite this low risk of injury to the triradiate cartilage after a Gill or Pemberton acetabuloplasty, long-term follow-up is recommended to observe acetabular development. Premature closure is most likely to occur if the bone graft used to maintain fragment displacement crosses the triradiate cartilage.

Acetabulum↗
PubMed1990

Technique and long-term results of acetabuloplasty.

Acetabuloplasty with lateral osteotomy of the pelvis in combination with intertrochanteric derotation-varus osteotomy was performed in our hospital between 1970 and 1976. Ninety hip joints have been reexamined recently after cessation of growth. Measurements of the acetabula show normal results in more than 80% of the cases. Measurements of the femoral neck and head, however, were normal in many fewer cases. Revalgization to a "head-in-neck position" or "subcapital coxa valga" was found in 40% of the joints, while the position of the acetabuloplasty remained without significant change if the technique was correct. Additional varus osteotomy was no longer performed after 1978 with consequent improvement in the results of acetabuloplasty.

Acetabulum↗
PubMedDate not supplied

Complications in acetabuloplasty in the treatment of CHD during the growth age.

The authors analyze the complications of acetabuloplasty in the treatment of CHD during the growth age, evaluating the incidence and the possible causes, that emerged from a review of cases at the Rizzoli Orthopaedic Institute including 238 patients treated from 1970 to 1986 using different methods. The techniques adopted were: acetabuloplasty for lowering in 100 cases, Salter osteotomy in 30 cases, triple pelvic osteotomy in 48 cases and acetabuloplasty according to the Chiari method in 50 cases. Complications of various types were observed in 9.6% of the cases after a mean follow-up of 5 years. It is the purpose of ths study to discuss the complications that are observed during each operation, and to compare them with those reported in the literature, as well as to present a pathogenetic interpretation. A study of complications influences indications and surgical technique.

Acetabulum↗
PubMed1996

Combined acetabuloplasty and varus derotation osteotomy in congenital dislocation of the hip. Long-term results.

Twenty-two patients (33 hips) with congenital dislocation of the hip were examined at an average of 26 years after combined acetabuloplasty and intertrochanteric varus derotation osteotomy. Seventeen patients had no problems despite physically demanding jobs and sporting activities in some cases. The CE angle was improved to the lower end of the normal range. The shaft-neck angle was corrected by 31 degrees to 120 degrees. Restoration to the normal valgus subsequently occurred and we found no evidence of subcapital coxa valga. Although there was an increase in the neck epiphysis angle 5 years after operation indicating a horizontal shift in the epiphyseal plate, most cases had normal hip joints. The incidence of postoperative avascular necrosis of the femoral head was 6%, and we found no increase in femoral deformities. Our long-term results show that the combination of acetabuloplasty and femoral osteotomy has no disadvantages, and is the best way of achieving optimal centring of the femoral head and stabilisation of the hip.

Acetabulum↗
PubMedDate not supplied

[Long-term results of acetabuloplasty].

The results of a modified acetabuloplasty after Albee-Lance performed simultaneously with a derotation-varusosteotomy (DVO) are investigated after cessation of growth. Measurements of the acetabulum have been normal or slightly pathologic after our classification system in 82-93%, while the values of the femoral head and neck showed a higher pathologic percentage. This is due to avascular necrosis after conservative or operative treatment, insufficient open reductions in a smaller number, but in the most cases caused by increased revalgisation after DVO. We have therefore performed acetabuloplasty since several years without DVO in the most cases, so far with good results.

Acetabulum↗
PubMed1996

Dega acetabuloplasty combined with intertrochanteric osteotomies.

Between 1973 and 1984, 70 modified Dega acetabuloplasties done simultaneously with intertrochanteric osteotomies in 51 patients with developmental dysplasia of the hip were reviewed for long-term results and analyzed for causes of failure. Mean patient age at operation was 2.9 years (range, 8 months-8 years), and mean followup time was 15.2 years (range, 10-19 years). Topical investigations were based on clinical criteria of the Severin classification and radiologic criteria of the Commission for the Study of Hip Dysplasia of the German Society of Orthopaedics and Traumatology. The review of clinical documents and investigations very good and good results in 80% of the hips. The Trendelenburg sign was a useful clinical indicator for problematic cases. Measurements on radiographs were classified into deviation grades from the normal range. Values of the acetabulum and the acetabulum to head relation were normal or slightly abnormal in >80% of hips. Measurements of the femoral head and neck were in the low normal range. The lowest percentage of normal values was in 24 cases with coxa valga after acetabuloplasty combined with derotational varus osteotomy. Poor clinical and radiologic outcome usually was the result of avascular necrosis of the femoral head or recurring valgus deformity after derotational varus osteotomy. The rate of avascular necrosis as a consequence of the operation was 5.7%. The risk of avascular necrosis caused by derotational varus osteotomy is lower than the risk of later development of deformities in the proximal femur.

Acetabulum↗
PubMed2004

Lateral shelf acetabuloplasty in the early stage of Legg-Calvé-Perthes disease with special emphasis on the remaining growth of the acetabulum: a preliminary report.

This study reports on the preliminary results in 43 patients with an early stage of unilateral Legg-Calvé-Perthes disease, treated with a shelf acetabuloplasty. The mean postoperative follow-up was 3.7 years (1.3-6.2 years). The results suggest an improved outcome in children older than 5 years of age at onset. According to the Stulberg classification, 16 hips were classified as Stulberg 2, 19 hips as Stulberg 3 and eight hips as Stulberg 4. The acetabular size, which is a measurement of the length of the acetabulum relative to the size of the shelf, increased from 48.86 to 69.13%. This reflects an incorporation of the shelf-graft into the pelvis as a result of continued growth of the lateral acetabular structures. The coverage of the femoral head by the bony acetabulum increased from 68.51 to 73.83%. The acetabular cover increases in children younger than 8 years of age and decreases in patients older than 8 years. We suggest that shelf acetabuloplasty can be considered as an appropriate surgical treatment for children older than 5 years of age, with severe Legg-Calvé-Perthes disease.

Acetabulum↗
PubMed2004

Lateral shelf acetabuloplasty in the treatment of Legg-Calvé-Perthes disease.

Although head containment is extremely important for the development of the acetabulum and femoral head, there are debates about conservative and surgical treatment. Shelf acetabuloplasty is an effective means of treatment as regards the coverage of the femoral head within the acetabulum, which is the most important issue for the normal development of the hip joint. Nineteen hips of 18 patients were evaluated radiographically using the acetabulum-head index of Heyman and Herndon and the center-edge angle for containment. It was shown that postoperatively both indices improve to increase the containment, thus demonstrating the effectiveness of shelf acetabuloplasty.

Acetabulum↗
PubMed1978

Pemberton's acetabuloplasty for congenital dislocation or subluxation of the hip.

The results obtained in a consecutive series of thirty-seven Pemberton operations for congenital dislocation or subluxation of the hip are reported. Over the period under review, 1967 to 1973, it was the only type of acetabuloplasty employed at Winford. Unless the mandatory concentric reduction could be obtained with ease, preliminary open reduction was favoured, especially in cases of primary care. Femoral rotation osteotomy was added for marked anteversion. The programme was designed to be complete inside fourteen weeks, and was so for eighteen hips. Secondary acetabuloplasty was performed on hips with instability or dislocation persisting despite previous treatment. The operations were performed from eighteen months to thirteen years of age. One initial failure required a repeat operation which was successful, but one severely dysplastic hip remained so. The average follow-up was six years.

Acetabulum↗
PubMed1999

Lateral shelf acetabuloplasty in Perthes' disease. A review of the end of growth.

The surgical treatment of Perthes' disease by femoral or innominate osteotomy is not as effective in those over the age of eight years as it is in the younger child. This has prompted the search for other types of management in those who are older. The preliminary results of the use of a lateral shelf acetabuloplasty for such cases have shown encouraging results at two years. The concern with such an operation is that it might interfere with the growth of the outer aspect of the acetabulum and so prejudice the long-term outcome. We describe a review at maturity of 26 children presenting with early disease after the age of eight years who were treated by lateral shelf acetabuloplasty. The results suggest that the outcome is improved; 22 of 27 hips were rated as Stulberg groups 1 to 3. Poor results occurred in children, particularly girls, presenting with Group-4 disease over the age of 11 years.

Acetabulum↗
PubMed1975

Acetabuloplasty in the treatment of congenital dislocation of the hip.

The results in 102 acetabuloplasties have been assessed in eighty-six patients, with a minimum follow-up of five years. Clinical and radiological assessment was carried out according to a score system very similar to that used in previous studies, and the results were expressed as excellent, good, fair and poor according to the score obtained. Any hip requiring further stabilising procedures was automatically grouped as a failure. Subtrochanteric femoral ostestomy was used when femoral anteversion was excessive. The results revealed that 73 per cent of the hips were satifactory (excellent or good) overall, but that a steady deterioration was evident when the five- and fifteen-year groups were compared. Few of the hips were regarded as normal on radiological grounds. Homologous bone bank rib was found to be the most satisfactory graft material. Coxa magna was the most common abnormality that was consistent with a good or excellent result. Avascular necrosis of the femoral head was found in only six hips; it was more commonly present in patients subjected to previous operation. Concentric reduction of the femoral head is essential if acetabuloplasty is to maintain stability of the hip.

Acetabulum↗
PubMed2001

Shelf acetabuloplasty for Perthes' disease: 12-year follow-up.

The goal of all therapies for Perthes' disease is to achieve an optimal shape of the acetabulum and an optimal coverage of the femoral head. Thirty patients who were included in this follow-up study (mean follow-up 12 years) underwent a shelf acetabuloplasty for Catterall group III or IV. The mean IOWA hip score at follow-up was 96 (max. 100 points, range 74-100). The mean acetabular-head quotient increased from 82.9% pre-operatively to 107.9% postoperatively, and remained 102.4% at follow-up. There was a decrease in mean lateral subluxation ratio from 1.44 pre-operatively to 1.27 postoperatively, which remained 1.23 at follow-up. According to the Stulberg classification in the 18 adult hips, 6 hips had a good result (Stulberg 1 or 2), 10 hips had a fair result (Stulberg 3), and 2 hips had a poor result (Stulberg 4 or 5). These results appear to be better than the natural history as described by Stulberg. Shelf acetabuloplasty can be considered as an appropriate surgical treatment for severe cases of Perthes' disease.

Acetabulum↗