According to the Harris hip score 80.4 % of the patients showed good and very good results after 11.5 years. In cases with arthrosis and obesity a higher rate of poor results were found.
A successful treatment requires not only experience in performing the surgical technique, but furthermore an experienced team, including care, physical examination and also pain management. The surgeon should be aware that he is performing highly elective surgery and complications or a poor outcome can significantly reduce the quality of life of the mainly young patients.
From 1999 to 2008, according to a prospective and sequential compilation of data, the 12,590 hip operations (11,059 in adults and 1,531 in children) performed in our hospital showed a postoperative complication rate of 4.96% (5.2% in adults and 1.96% in children). The most frequent complications were 110 thromboses (0.87%), which were clinically apparent and proven by Doppler ultrasonography or phlebography; 191 superficial and deep disorders of wound healing (1.5%), including 57 (0.45%) infections; 88 peripheral nerve lesions (0.7%); and 53 hematoma revisions (0.42%). Operation-specific statistics for complications (total hip replacements, revisions, femoral and pelvic osteotomies, hardware removals, and operations in children, including acetabuloplasty, femoral osteotomies, and open reductions) are presented here. Those statistics make it possible to judge and compare method-specific and department-specific risks and their development over time. An open and active attitude when dealing with postoperative complications can cost effectively and efficiently improve treatment results.
Deformity and malposition of the acetabulum can occur during the development of the hip. Developmental hip dysplasia and acetabular retroversion are possible causes of osteoarthritis in the young adult. Surgical management with reorientation of the acetabulum allows causal therapy of the deformity and preservation of the native hip joint. Established techniques are the Bernese periacetabular osteotomy (PAO) and the Tönnis and Kalchschmidt triple osteotomy of the pelvis. Both techniques permit three-dimensional correction of the position of the acetabulum. Advantages and disadvantages of each technique must be considered and are summarized in the present paper. If performed early (osteoarthritis grade Tönnis 0 and 1) with correct indication and proper technique, good results can be expected.
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