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Abstract
Purpose
The goal of this study was to analyze the short to midterm results of Bernese periacetabular osteotomy for the patient with hip dysplasia.
Materials and Methods
Fourteen Bernese periacetabular osteotomies were performed in 13 patients and were followed-up for more than 2.5 years. All patients had been treated at Department of Orthopedic Surgery, Seoul National University Hospital from June 1998 to December 2007. We conducted an interview and asked the patients to complete the Harris hip score and pain visual analogue scale (VAS) score for clinical evaluation. Radiographic measurements included Tönnis osteoarthritis grade, center-edge angle of Wiberg, acetabular angle of Sharp, acetabular depth index, acetabular head index.
Results
Mean Harris hip score improved from 63.8 points preoperatively to 82.9 points postoperatively and pain VAS score improved from 7.6 points preoperatively to 0.8 points postoperatively. Based on Tönnis osteoarthritis grade, progression of osteoarthritis was found in 4 hips. Radiologically, center-edge angle of Wiberg, acetabular angle of Sharp, acetabular depth index and acetabular head index improved. Complications included superficial skin infection in one hip and non-union of pubic ramus in one. One patient had metal hypersensitivity to cortical screws and fracture of posterior column.
Figures and Tables
Figure 1
The diagram shows radiographic measurements. (A) Center-edge angle of Wiberg, (B) acetabular angle of Sharp, (C) acetabular depth index: a/b×1,000, (D) acetabular head index: a/b×100.
Figure 2
The flow chart shows the postoperative osteoarthritic changes depending on the preoperative Tönnis osteoarthritis grade.
Figure 3
Radiographs are obtained from a 50-year-old female patient who underwent a Bernese periacetabular osteotomy. (A) Preoperative radiograph (anteroposterior). (B) Postoperative radiogarphs taken at 3 years after surgery (anteroposterior & oblique). (C) Radiogarph at 8 years after surgery (anteroposterior & oblique). (D) Radiograph at 13 years after surgery (anteroposterior).
Figure 4
Anteroposterior radiographs are showing the hips and pelvis of a 47-year-old woman who was managed with a Bernese periacetabular osteotomy. (A) Preoperative radiograph. (B) Postoperative radiogarphs taken at 1 year after surgery of the right hip. (C) Immediate postoperative radiogarphs of the left hip. (D) Radiograph at 3 years after surgery of the left hip.
Table 1
Data on the Radiographic Findings
Values are presented as median (range). For the evaluation of coverage of femoral head, center-edge angle of Wiberg was checked. To evaluate the inclination of acetabulum, acetabular angle of Sharp was checked. And to evaluate the depth of acetabulum, acetabular depth index and acetabular head index were compared.
References
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