A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia

Konya, Mehmet Nuri; Tuhanioğlu, Ümit; Aslan, Ahmet; Yıldırım, Timur; Bursalı, Ayşegül; Şahin, Vedat; Demir, Bilal

doi:10.5606/ehc.2013.22

Cited by 13 publications

(13 citation statements)

References 15 publications

(22 reference statements)

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“…At present, early diagnosis and treatment constitute the most important factors for the successful treatment of DDH. Fewer surgical interventions are performed in patients diagnosed at an early age and stage, with a higher number of successful results (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

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Effect of Age and Surgical Procedure on Clinical and Radiological Outcomes in Children with Developmental Dysplasia of the Hip: A Comparative Study

Yorgancigil¹,

Aslan²,

Demirci³

et al. 2016

JAREM

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Section: Discussionmentioning

confidence: 99%

“…DDH is one of the most important childhood orthopedic pathologies and a health problem that may lead to a disability if it remains untreated or is diagnosed late (5,6). The main problem with respect to all stages of DDH treatment is the reduction of the hip and correction of instability in the joint.…”

Section: Introductionmentioning

confidence: 99%

Effect of Age and Surgical Procedure on Clinical and Radiological Outcomes in Children with Developmental Dysplasia of the Hip: A Comparative Study

Yorgancigil¹,

Aslan²,

Demirci³

et al. 2016

JAREM

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“…Secondary degenerative arthritis has been seen in young patients who were treated later than and less sufficiently than recommended, or who were neglected may be reduced with proper treatment. [28][29][30][31] Conservative methods and closed reduction are attempted first. However unstable closed reduction usually results in unsatisfactory function.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip

Yorgancigil

Aslan

2016

Eklem Hastalik Cerrahisi

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ÖZ Amaç:Bu çalışmada gelişimsel kalça displazisi (GKD) nedeniyle medial veya anterior yaklaşımla açık redüksiyon uygulanan çocuklarda cerrahi yaklaşımın klinik ve radyolojik sonuçlar, avasküler nekroz (AVN) insidansı ve revizyon cerrahisi gerekliliği üzerindeki etkileri araştırıldı. Hastalar ve yöntemler: Ocak 1997 -Aralık 2010 tarihleri arasında GKD tedavisi yapılan, en az dört yıl düzenli takip edilen ve son kontrolde beş yaş ve üzerinde olan 36 hastanın (9 erkek, 27 kız; ort. yaş 13.8 ay; dağılım 6-18 ay) 43 kalçası bu retrospektif çalışmaya dahil edildi. Hastalar cerrahi yaklaşıma göre iki gruba ayrıldı. Grup 1, medial yaklaşımla açık redüksiyon uygulanan 19 hastanın 21 kalçasından oluştu. Grup 2, anterior yaklaşımla açık redüksiyon uygulanan 17 hastanın 22 kalçasından oluştu. Gruplar klinik ve radyolojik sonuçlar ile AVN insidansı ve revizyon cerrahisi gerekliliği bakımından karşılaştırıldı. Bulgular: Klinik ve radyolojik sonuçlar bakımından gruplar arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p= 0.407 ve p= 0.661). Benzer şekilde, AVN insidansı ve revizyon cerrahisi gerekliliği bakımından da gruplar arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p= 0.993 ve p= 0.170). Diğer yandan, takipte her iki grubun asetabüler indeksi anlamlı olarak düzelmişti. Sonuç: Bu çalışma, GKD'de medial veya anterior yaklaşım ile açık redüksiyonun klinik ve radyolojik sonuçlarının benzer olduğunu, her iki yaklaşımla da asetabüler indekste anlamlı düzelme elde edildiğini ve AVN insidansı ve revizyon cerrahisi gerekliliği bakımından gruplar arasında anlamlı farklılık olmadığını göstermiştir.Anahtar sözcükler: Anterior açık redüksiyon; avasküler nekroz, gelişimsel kalça displazisi; medial açık redüksiyon; revizyon cerrahisi. ABSTRACT Objectives:This study aims to investigate the effects of surgical approach on the clinical and radiological outcomes, the incidence of avascular necrosis (AVN), and the need for revision surgery in children undergoing open reduction via medial or anterior approach for developmental dysplasia of the hip (DDH). Patients and methods: Forty-three hips of 36 patients (9 males, 27 females; mean age 13.8 month; range 6 to 18 months) treated for DDH, followed-up regularly for at least four years between January 1997 and December 2010, and who were aged five or above in the final control were included in this retrospective study. Patients were divided into two groups according to surgical approaches. Group 1 consisted of 21 hips of 19 patients who underwent open reduction through medial approach. Group 2 consisted of 22 hips of 17 patients who underwent open reduction through anterior approach. Groups were compared in terms of clinical and radiological outcomes as well as the incidence of AVN and the need for revision surgery. Results: There was no statistically significant difference between the groups with respect to clinical and radiological outcomes (p=0.407 and p=0.661, respectively). Similarly, there was no statistically significant difference between the groups in...

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“…4 The goal of corrective surgery in the treatment of HD is to improve the function while relieving pain, delaying and possibly preventing the end-stage arthritis. 5,6 Different kinds of periacetabular osteotomies including innominate osteotomies, 7–11 juxta-articular triple osteotomies, 12 periacetabular osteotomies, 13 and spherical osteotomies 14,15 have been described to solve this problem. Tönnis triple pelvic osteotomy (TPAO) is 1 of the popular surgical osteotomies described and are still used since 1978.…”

Section: Introductionmentioning

confidence: 99%

Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results

et al. 2016

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Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO.Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre–postoperative, anterior–posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre–postoperative scores also the amount of improvement in all parameters were analyzed.SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann–Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant.Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2–10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre–postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD group. Extension, impingement, TS, VAS, HHS, WOMAC score parameters in clinical outcome and LCE, ACE, Sharp angle, coverage ratio in radiological results were significantly better in PAD group postoperatively but in RAD group; only extension, VAS, HHS, and WOMAC parameters were clinically and LCE and Coverage ratio were significantly different compared with the preoperative measurements. The change of the parameters that used for the evaluation of clinical and radiological results did not show a significant difference between groups.Our data suggest that TPAO can be performed on patients with HD for both groups. Although there were fewer parameters which changed significantly after TPAO in RAD patients; the improvement of radiological and clinical results was similar for groups. Further long-term follow-up studies with large number of patients are needed to determine the proper results of TPAO.

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A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia

Cited by 13 publications

References 15 publications

Effect of Age and Surgical Procedure on Clinical and Radiological Outcomes in Children with Developmental Dysplasia of the Hip: A Comparative Study

Effect of Age and Surgical Procedure on Clinical and Radiological Outcomes in Children with Developmental Dysplasia of the Hip: A Comparative Study

Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip

Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results

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