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Effect of Prior Salter or Chiari Osteotomy on THA with Developmental Hip Dysplasia

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Controversy exists regarding the outcome of THA after prior pelvic osteotomy.

Questions/purposes

We conducted a retrospective chart and radiographic review to obtain outcome measures for perioperative complications, acetabular and femoral component revisions, Harris hip score, and survivorship and compared these outcomes for patients presenting with developmental dysplasia of the hip treated surgically using THA with and without prior pelvic osteotomy.

Patients and Methods

We performed 103 primary THAs in 87 patients with osteoarthritis secondary to developmental dysplasia of the hip with a minimum 3-year followup. Previous pelvic osteotomy was performed in 52 hips (Salter, 40; Chiari, nine; Salter and Chiari, three), and 51 hips had no previous surgery (control group).

Results

The pelvic osteotomy group did not have higher rates of femoral or acetabular intraoperative fracture or dislocation compared with the control group. The overall revision rate was 28.8% in the pelvic osteotomy group compared with 19.6% in the control group. The revision rate for aseptic loosening was 23.1% in the pelvic osteotomy group compared with 17.6% in the control group. Harris hip scores (range, 20–87) were not compromised, and overall survivorship rates 8 years postoperatively were not different at any time between the pelvic osteotomy (83.3%) and control (88.4%) groups.

Conclusions

Prior pelvic osteotomy did not lead to a higher perioperative complication rate, higher revision rate, compromised Harris hip score, or shortened survivorship in eventual THA in developmental dysplasia of the hip.

Level of Evidence

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Jun Saito, MD, PhD, and Kazuhiko Inoue, MD, PhD, for valuable help during this study. We recognize Kerry Ann Griffith-Cunningham and Jane Morton, RN (Orthopaedics, St Michael’s Hospital) for their assistance in obtaining and keeping records of patient data. The assistance of Abdulaati Mahfud, MD (Martin Orthopaedic Biomechanics Lab, St Michael’s Hospital) in tracking down a few key references also is appreciated. Finally, we acknowledge Muhammad Mamdani, PharmD, MPH, MA, and Rosane Nisenbaum, PhD (Applied Health Research Centre, St Michael’s Hospital) for their consultation and work on some statistical matters.

Author information

Authors and Affiliations

  1. Martin Orthopaedic Biomechanics Laboratory, Shuter Wing (Room 5-066), St Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B-1W8, Canada

    Kenji Tokunaga MD, Nadim Aslam MD, FRCSC & Rad Zdero PhD

  2. Division of Orthopaedic Surgery, St Michael’s Hospital, Toronto, ON, Canada

    Emil H. Schemitsch MD, FRCSC & James P. Waddell MD, FRCSC

Authors
  1. Kenji Tokunaga MD
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  2. Nadim Aslam MD, FRCSC
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  3. Rad Zdero PhD
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  4. Emil H. Schemitsch MD, FRCSC
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  5. James P. Waddell MD, FRCSC
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Corresponding author

Correspondence to Rad Zdero PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a 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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Tokunaga, K., Aslam, N., Zdero, R. et al. Effect of Prior Salter or Chiari Osteotomy on THA with Developmental Hip Dysplasia. Clin Orthop Relat Res 469, 237–243 (2011). https://doi.org/10.1007/s11999-010-1375-8

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  • DOI: https://doi.org/10.1007/s11999-010-1375-8

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