Exercise testing after the Chiari pelvic osteotomy

Macnicol, Malcolm F.; Uprichard, H; Gp, Mitchell

doi:10.1302/0301-620x.63b1.7204474

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…Long-term review inevitably shows a decline in the relief from pain, with an associated decrease in function. 16,17 As shown in the Kaplan-Meier survival graph (Fig. 2) there are some relatively early revisions, although the survival at 20 years was almost 95%.…”

Section: Discussionmentioning

confidence: 94%

“…Cover of at least 80% should be achieved, but there is no merit in excessive displacement producing greater than 100% cover since union of the osteotomy may be impaired and a limp may persist. 17 Remod-elling of the pelvis does not reduce support of the head although associated coxa valga may require correction. 3,18 The alteration in architecture of the pelvic wall largely affects the medial pillar and the brim, producing remodelling which may not be seen after a Salter osteotomy of the mature pelvis.…”

Section: Discussionmentioning

confidence: 99%

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Pelvic remodelling after the Chiari osteotomy

Macnicol

Lo²,

Yong

2004

The Journal of Bone and Joint Surgery. British volume

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Survivorship analysis of 215 medial displacement pelvic osteotomies undertaken for symptomatic, incongruent dysplasia of the hip since 1966 showed that four of every five hips had not required conversion to a total hip arthroplasty. The radiological characteristics of 86 osteotomies were evaluated at a mean of 18 years (5 to 30) after surgery which was performed at the age of 15.9 +/- 9.5 years. Revision was significantly (p < 0.05) more likely in those patients operated on after the age of 25 years. The centre-edge (CE) angle increased from 2.5 +/- 13.9 degrees before to 41.8 +/- 15.0 degrees immediately after operation. The increase in CE angle was maintained at later review (38.5 +/- 16.5 degrees). Even with severe dysplasia with a CE angle less than zero a substantial improvement in the cover of the femoral head was achieved, usually by medial shift of the lower pelvic fragment. However, the head was not invariably medialised by the osteotomy and lateral movement of the ilium was noted when the position of the joint was relatively medial before operation or when the hip was arthritic. In the longer term pelvic remodelling did not reverse the medialisation produced by the osteotomy, and the cover of the femoral head was maintained.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Pelvic remodelling after the Chiari osteotomy

Macnicol

Lo²,

Yong

2004

The Journal of Bone and Joint Surgery. British volume

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“…- The 1MSCT : The patient is invited to walk up and down stairs (one step at a time) for 1 min, the score being the total number of steps climbed [6].…”

Section: Methodsmentioning

confidence: 99%

“…Many performance tests are currently being used by clinicians, especially in rehabilitation centers. Among these tests, the 6-min walk test (6MWT) [4], the Steep Ramp Test (SRT) [5], the 1-Minute Stair Climbing Test (1MSCT) [6], the Sit-To-Stand test (STS) [7], the Jamar dynamometer test (JAM) [8] and the lumbar protocol of the Progressive Isoinertial Lifting Evaluation (PILE) [9] are widely used in patients with musculoskeletal, neurological, cardiac or pulmonary disease. These tests are easy to administer and do not require expensive devices.…”

Section: Introductionmentioning

confidence: 99%

“Minimal clinically important difference” estimates of 6 commonly-used performance tests in patients with chronic musculoskeletal pain completing a work-related multidisciplinary rehabilitation program

Benaïm

Blaser

Léger

et al. 2019

BMC Musculoskelet Disord

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BackgroundFunctional tests are widely used to measure performance in patients with chronic musculoskeletal pain. Our objective was to determine the Minimal Clinically Important Differences (MCID) for the 6-min walk test (6MWT), the Steep Ramp Test (SRT), the 1-min stair climbing test (1MSCT), the sit-to-stand test (STS), the Jamar dynamometer test (JAM) and the lumbar Progressive Isoinertial Lifting Evaluation (PILE) in chronic musculoskeletal pain patients.MethodsA single-center prospective observational study was conducted in a rehabilitation center. Patients with upper-limb, lower-limb or neck/back lesions were included over a period of 21 months. We used the anchor-based method as a reference method, supplemented by the distribution-based and opinion-based approaches, to determine the MCIDs.Results838 chronic musculoskeletal pain patients were included. The estimation method and thelesion location had a significant influence on the results. MCIDs were estimated at +75m and +60m for the 6MWT (lower-limb and neck/back lesions, respectively), +18 steps for the 1MSCT (lower-limb and neck/back lesions) and +6kg for the JAM (upper limb lesions). The anchor-based method could not provide valid estimations for the three other scales, but distribution and opinion-based methods provided rough values of MCIDs for the SRT (+39w to +61w), the STS (-5 sec to -7 sec) and the PILE (+4kg to +7kg).ConclusionThe above MCID estimations for the 6MWT, 1MSCT and JAM can be used in chronic musculoskeletal pain patients participating in vocational multidisciplinary rehabilitation programs or in therapeutic trials. The use of specific anchors might give better estimations of MCIDs for the three other scales in future research.

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“…Mannor et al [26] recorded a revision rate of 20% 2-19 years after Chiari osteotomy. Long-term review inevitably shows a decline in the relief from pain, with an associated decrease in function [27,28]. In a long-term review, Macnicol et al [21] showed that although there are some relatively early revisions, the survival at 20 years is almost 95%.…”

Section: Chiari Pelvic Osteotomy In Developmental Dysplasia Of the Hi...mentioning

confidence: 99%

The results of Chiari pelvic osteotomy in adolescents with a brief literature review

Karami

Fitoussi

Ilharreborde

et al. 2008

Journal of Children's Orthopaedics

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Purpose Chiari medial displacement osteotomy is a procedure that uses the cancellous bone of the ilium to contain the femoral head and bear weight. It is the most contraversial osteotomy of the hip joint. This study was therefore conducted to determine the results of this osteotomy with mid-term follow-up in children. From 1995From to 2004 Chiari pelvic osteotomies (in 18 patients) were performed. There were 15 male and 3 female patients. The average age at operation was 12.6 years and the mean follow-up was 54 months. The operative technique was as described by Chiari. An iliofemoral approach was used without utilizing a traction table. If there was anterior or anterolateral uncoverage of the femoral head, bone graft augmentation was performed. Results The angle of the osteotomy averaged 12°, with the distance from the acetabulum averaging 3.2 mm. The average displacement was 42%. Of the 20 Chiari osteotomies, 11 were categorized as excellent, 8 as good and one as fair in terms of clinical and radiological results. Student's t test statistics showed improvements in all radiologic parameters of the hip joint (Sharp angle, centeredge angle and coverage of the femoral head). Graft resorption was observed in 25% of the patients. MethodsConclusion There are very rare indications of Chiari osteotomy in patients younger than 10 years. Because of the high rate of graft resorption, Chiari osteotomy should be the last treatment option when there is anterior or anterolateral uncoverage of the hip joint.

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Exercise testing after the Chiari pelvic osteotomy

Cited by 7 publications

References 2 publications

Pelvic remodelling after the Chiari osteotomy

Pelvic remodelling after the Chiari osteotomy

“Minimal clinically important difference” estimates of 6 commonly-used performance tests in patients with chronic musculoskeletal pain completing a work-related multidisciplinary rehabilitation program

The results of Chiari pelvic osteotomy in adolescents with a brief literature review

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