Clinical Orthopaedics and Related Research®

, Volume 470, Issue 12, pp 3439–3445 | Cite as

What Are the Factors Associated With Acetabular Correction in Perthes-like Hip Deformities?

  • John C. Clohisy
  • James R. Ross
  • Joshua D. North
  • Jeffrey J. Nepple
  • Perry L. Schoenecker
Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery

Abstract

Background

Perthes-like hip deformities encompass variable proximal femoral abnormalities and associated acetabular dysplasia that can be reconstructed with contemporary hip preservation procedures. Nevertheless, the necessity and indications for surgical correction of associated acetabular dysplasia have not been established.

Questions/Purposes

We determined whether patient-specific factors (sex, age, BMI, previous surgery, hip pain and function) and/or structural deformity characteristics (radiographic parameters of acetabular morphology) were associated with our indications for acetabular reorientation in surgical reconstruction of Perthes-like hip deformities.

Methods

We compared patient-specific characteristics and radiographic parameters of acetabular morphology in 94 patients (97 hips) with residual Perthes deformities who underwent joint preservation surgery without or with a periacetabular osteotomy (PAO) as part of the reconstruction.

Results

Patient sex, BMI, preoperative Harris hip score, and previous hip surgery were not associated with our indications for a combined femoral and PAO procedure. Radiographic parameters associated with the indication for a PAO included the lateral center-edge angle, anterior center-edge angle, acetabular inclination, and acetabulum-head index. No or mild secondary osteoarthritis and joint congruency were associated with the indication for a PAO as part of the reconstruction.

Conclusions

Contemporary hip preservation surgery for residual Perthes deformities covers a wide spectrum of procedures. We believe a PAO should be considered in the surgical treatment plan for symptomatic patients having radiographic parameters indicating acetabular dysplasia, no or mild secondary osteoarthritis, and adequate joint congruity.

Level of Evidence

Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

Notes

Acknowledgments

We thank Debbie Long for assistance with the preparation of this manuscript.

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Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • John C. Clohisy
    • 1
  • James R. Ross
    • 1
  • Joshua D. North
    • 1
  • Jeffrey J. Nepple
    • 1
  • Perry L. Schoenecker
    • 1
  1. 1.Department of Orthopaedic SurgeryWashington University School of MedicineSt LouisUSA

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