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Effect of Pelvic Osteotomy in the Skeletally Immature on Acetabular Coverage

  • Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip
  • Published:
HSS Journal ®

Abstract

Background

Although pelvic osteotomy in children has been effective in re-establishing containment of the hip joint, its impact on hip joint development with respect to acetabular coverage is ill defined.

Purpose

The purpose of this study is to determine the prevalence of acetabular overcoverage in patients who had pelvic osteotomy during childhood and its impact on patient function.

Patients and Methods

Between 1980 and 2008, all patients who had a pelvic osteotomy done at our institution for non-neuropathic hip dysplasia (DDH) or secondary to Legg–Calvé–Perthes disease (LCP) prior to skeletal maturity were reviewed. A clinical assessment and the WOMAC, UCLA Activity Score, Marx activity score, and SF-36 quality-of-life questionnaires were completed. A standardized AP pelvic X-ray was performed to determine the acetabular coverage, signs of retroversion, and degenerative changes.

Results

Twenty-eight patients (32 hips) were identified, of which 14 (9 DDH, 5 LCP) agreed to participate. Impingement sign was positive in eight patients (six DDH, two LCP). Crossover and ischial spine signs were each present in ten hips. Tonnis grades were: 0 in 1 hip, 1 in 10 hips, 2 in 2 hips, and 3 in 1 hip. The mean Tonnis angle was 11.6 ± 8.6°. The mean CE angle was 24.0 ± 15.9° with six hips having a CE angle <20° and one hip with a CE angle >40°. There was no correlation between crossover sign or ischial sign and Tonnis grade (p = 0.739), hip pain (p = 0.520), or impingement sign (p = 1.00).

Conclusions

Acetabular overcoverage is common in patients who underwent pelvic osteotomy during childhood. No correlation was identified between retroversion and hip pain in our patient cohort.

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Disclosures

The authors declare that they have no conflict of interest. Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a significant conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Authors and Affiliations

  1. University of Ottawa, Ottawa, ON, Canada

    Sulaiman Al-Moussa MD, FRCSC, Paul Moroz MD, FRCSC & Paul E. Beaulé MD, FRCSC

  2. University of Ottawa, The Ottawa Hospital, 501 Smyth Rd., CCW 1646, Ottawa, ON, Canada, K1H 8L6

    Paul E. Beaulé MD, FRCSC

Authors
  1. Sulaiman Al-Moussa MD, FRCSC
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  2. Paul Moroz MD, FRCSC
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  3. Paul E. Beaulé MD, FRCSC
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Corresponding author

Correspondence to Paul E. Beaulé MD, FRCSC.

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Level of Evidence

Prognostic study, level IV (case series). See the guidelines for authors for a complete description of levels of evidence.

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Al-Moussa, S., Moroz, P. & Beaulé, P.E. Effect of Pelvic Osteotomy in the Skeletally Immature on Acetabular Coverage. HSS Jrnl 8, 235–239 (2012). https://doi.org/10.1007/s11420-012-9286-8

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  • DOI: https://doi.org/10.1007/s11420-012-9286-8

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