Biomechanical evaluation of hip joint after Salter innominate osteotomy: a long-term follow-up study

Abstract

The biomechanical state of the hip after a Salter innominate osteotomy was investigated by using the radiographic data of 38 operated and 21 contralateral nonoperated hips from our archives. The centre-edge angle of Wiberg was determined from the radiographs taken shortly after the operation. From the radiographs of the latest follow-up (7-13 years after the operation), we also determined the peak value of contact hip joint stress normalized by the body weight, and the functional angle of the weight-bearing area. A mathematical model was used. We show that the geometrical parameters aside from the centre-edge angle may considerably influence the contact hip stress distribution. We also show that the functional angle of the weight-bearing area is a more relevant parameter than the normalized peak stress if the exact magnification of the images is not known and if there is considerable variation of the image size within the sample. The development of the centre-edge angle of the operated hips and of the contralateral hips was also studied. We found that the centre-edge angle increases on average during the follow-up time in the operated hips as well as in the contralateral nonoperated hips, but the average increase is smaller in the former. It is shown that an unfavorable stress distribution is connected to the decrease of the centre-edge angle over time. Finally, we found a weak positive correlation between the centre-edge angle shortly after the operation and the functional angle of the weight-bearing area at the of the latest follow-up.

Intertrochanteric osteotomy in young adults for sequelae of Legg-Calv�-Perthes? disease?a long term follow-up

“…Options for treatment on the acetabular side are Salter-type osteotomies [13,25], rotational acetabular osteotomies [6,8,15,22,26] and augmentation procedures like acetabular roof plasty [11,13,16,24]. In many cases, it is necessary to address both the acetabulum and the femoral head [1,5,14].…”

“…We could place bone grafts and cancellous bone wherever there was a need for it. A Salter osteotomy seems illogical as it only addresses the lateral and anterior side of the acetabulum [13,25]. A Chiari osteotomy will address especially the lateral side, but also the anterior and posterior side [8].…”

Impact of triple pelvic osteotomy on contact stress pressure distribution in the hip joint

“…The HIPSTRESS method was used in the analysis of healthy and dysplastic hip joints [17,18], various disorders of the hip [14,[19][20][21][22], and after different surgical procedures, e.g. corrective femoral osteotomies, and Salter, Chiari and Ganz pelvic osteotomy [12,18,19,[23][24][25][26]. It is now applied for the first time in the analysis and quantification of Tonnis triple pelvic osteotomy effects.…”

Cumulative Hip Contact Stress Predicts Osteoarthritis in DDH

“…Peak contact stress in the hip has been compared between different groups of patients with developmental dysplasia of the hip to evaluate outcomes of surgical procedures [12,37]. These and other experimental studies [29,36] and clinical reports [13,25] confirm patients with hip dysplasia have higher contact stress than healthy subjects.…”