Skip to main content
Log in

Total hip arthroplasty of dysplastic hip after previous Chiari pelvic osteotomy

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction: Many reports have suggested that Chiari pelvic osteotomy would improve the results of acetabular component placement and fixation in subsequent total hip arthroplasty. However, little is known concerning the biomechanical, radiological, and clinical effects of Chiari pelvic osteotomy on subsequent total hip arthroplasty. Materials and methods: Ten total hip arthroplasties for developmental dysplasia of the hip after previous Chiari pelvic osteotomy (Chiari group) were compared with 20 total hip arthroplasties for developmental dysplasia of the hip without previous surgery (control group). Preoperative patient demographic data and operative technique were well matched between the groups. The mean duration of follow-up was 3.0 years. Biomechanical, radiological, and clinical evaluations were performed. Results: No acetabular or femoral components exhibited loosening. All patients had good or excellent clinical score according to the Merle d’Aubigne-Postel rating system at the most recent follow-up. Abductor force and joint force were smaller in the Chiari group, although long operative time, more blood loss, and verticalization of joint force were noted in this group. Conclusion: This limited study suggested that Chiari pelvic osteotomy changed the biomechanical features of the hip joint, and that this alteration might have compromised subsequent total hip arthroplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Andrew AS, Harris WH (1997) Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty sixteen-year-average follow-up. J Bone Joint Surg Am 79:159–68

    Google Scholar 

  2. Chiari K (1974) Medial displacement osteotomy of the pelvis. Clin Orthop 98:55–71

    Article  PubMed  Google Scholar 

  3. Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23

    PubMed  CAS  Google Scholar 

  4. d’Aubigne RM, Postel M (1954) Function al results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36:451–475

    PubMed  Google Scholar 

  5. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop 121:20–32

    PubMed  Google Scholar 

  6. Dunn HK, Hess WE (1976) Total hip reconstruction in chronically dislocated hips. J Bone Joint Surg Am 58:838–845

    PubMed  CAS  Google Scholar 

  7. Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 69:45–55

    PubMed  CAS  Google Scholar 

  8. Fender D, van der Meulen JH, Gregg PJ (2003) Relationship between outcome and annual surgical experience for the charnley total hip replacement. Results from a regional hip register. J Bone Joint Surg Br 85:187–190

    Article  PubMed  CAS  Google Scholar 

  9. Graham S, Westin GW, Dawson E, Oppenheim WL (1986) The Chiari osteotomy. A review of 58 cases. Clin Orthop 208:249–258

    PubMed  Google Scholar 

  10. Greenwald AS (1991) Biomechanics of the hip. In: Steinberg M (ed) The hip and its disorders. WB Saunders, Philadelphia p 49

  11. Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27

    PubMed  Google Scholar 

  12. Hamilton H, Fung T, Rapley P (2003) Related articles, reconstruction for chronic dislocation of the hip. J Bone Joint Surg Br 85:802–808

    PubMed  CAS  Google Scholar 

  13. Hashemi-Nejad A, Haddad FS, Tong KM, Muirhead-Allwood SK, Catterall A (2002) Does Chiari osteotomy compromise subsequent total hip arthroplasty? J Arthroplasty 17:731–739

    Article  PubMed  CAS  Google Scholar 

  14. Herberts P, Malchau H (2000) Long-term registration has improved the quality of hip replacement: a review of the Swedish THR Register comparing 160,000 cases. Acta Orthop Scand 71:111–121

    Article  PubMed  CAS  Google Scholar 

  15. Hodgkinson JP, Shelley P, Wroblewski BM (1988) The correlation between the roentgenographic appearance and operative findings at the bone–cement junction of the socket in Charnley low friction arthroplasties. Clin Orthop 228:105–109

    PubMed  Google Scholar 

  16. Hoffman DV, Simmons EH, Barrington TW (1974) The results of the Chiari osteotomy. Clin Orthop 98:162–170

    Article  PubMed  Google Scholar 

  17. Hogh J, Macnicol MF (1987) The Chiari pelvic osteotomy. A long-term review of clinical and radiographic results. J Bone Joint Surg Br 69:365–373

    PubMed  CAS  Google Scholar 

  18. Iannotti JP, Balderston RA, Booth RE, Rothman RH, Cohn JC, Pickens G (1986) Aseptic loosening after total hip arthroplasty. Incidence, clinical significance, and etiology. J Arthroplasty 1:99–107

    Article  PubMed  CAS  Google Scholar 

  19. Kobayashi S, Saito N, Nawata M, Horiuchi H, Iorio R, Takaoka K (2003) Total hip arthroplasty with bulk femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip. J Bone Joint Surg Am 85:615–621

    PubMed  Google Scholar 

  20. Lack W, Windhager R, Kutschera HP, Engel A (1991) Chiari pelvic osteotomy for osteoarthritis secondary to hip dysplasia. Indications and long-term results. J Bone Joint Surg Br 73:229–234

    PubMed  CAS  Google Scholar 

  21. Mitchell GP (1974) Chiari medial displacement osteotomy. Clin Orthop 98:146–150

    Article  PubMed  Google Scholar 

  22. Nercessian OA, Joshi RP, Martin G, Su BW, Eftekhar NS (2003) Influence of demographic and technical variables on the incidence of osteolysis in Charnley primary low-friction hip arthroplasty. J Arthroplasty 18:631–637

    Article  PubMed  Google Scholar 

  23. Ohashi H, Hirohashi K, Yamano Y (2000) Factors influencing the outcome of Chiari pelvic osteotomy: a long-term follow-up. J Bone Joint Surg Br 82:517–525

    Article  PubMed  CAS  Google Scholar 

  24. Pagnano W, Hanssen AD, Lewallen DG, Shaughnessy WJ (1996) The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am 78:1004–1114

    PubMed  CAS  Google Scholar 

  25. Roder C, Parvizi J, Eggli S, Berry DJ, Muller ME, Busato A (2003) Demographic factors affecting long-term outcome of total hip arthroplasty. Clin Orthop 417:62–73

    PubMed  Google Scholar 

  26. Rodriguez JA, Huk OL, Pellicci PM, Wilson PD Jr (1995) Autogenous bone grafts from the femoral head for the treatment of acetabular deficiency in primary total hip arthroplasty with cement. Long-term results. J Bone Joint Surg Am 77:1227–1233

    PubMed  CAS  Google Scholar 

  27. Russotti GM, Harris WH (1991) Proximal placement of the acetabular component in total hip arthroplasty. A long-term follow-up study. J Bone Joint Surg Am 73:587–592

    PubMed  CAS  Google Scholar 

  28. Scher MA, Jakim I (1991) Combined intertrochanteric and Chiari pelvic osteotomies for hip dysplasia. J Bone Joint Surg Br 73:626–631

    PubMed  CAS  Google Scholar 

  29. Shinar AA, Harris WH (1997) Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg Am 79:159–168

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yukihide Minoda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Minoda, Y., Kadowaki, T. & Kim, M. Total hip arthroplasty of dysplastic hip after previous Chiari pelvic osteotomy. Arch Orthop Trauma Surg 126, 394–400 (2006). https://doi.org/10.1007/s00402-006-0141-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-006-0141-6

Keywords

Navigation