How are outcomes affected by performing a one-stage combined procedure simultaneously in bilateral developmental hip dysplasia?

Ağuş, Haluk; Bozoglan, Muhammet; Kalenderer, Önder; Kazımoğlu, Cemal; Önvural, Burak; Akan, İhsan

doi:10.1007/s00264-014-2330-1

Cited by 20 publications

(17 citation statements)

References 20 publications

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“…But, it has been shown in later studies that bilateral pelvic osteotomies could be performed in a safe manner. 11,32 We did not encounter any complications such as pelvic instability and loss of correction in patients who received simultaneous bilateral Salter osteotomy without open reduction. Smith's c/b ratio showing the lateralization of the femoral head and h/b ratio showing the superior displacement.…”

Section: Discussionmentioning

confidence: 78%

Salter osteotomy without open reduction in the Tönnis type II developmental hip dysplasia: A retrospective clinical study

Gürger

Demir

Yılmaz³

et al. 2019

J Orthop Surg (Hong Kong)

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Purpose: We aimed to evaluate the clinical and radiological outcomes of children older than 18 months who were treated with Salter osteotomy without open reduction for Tönnis type II hip dysplasia. Methods: Thirty-two type II hips of 24 patients were included in the study. The mean age was 43.22 (18–108) months. The mean follow-up period was 50 (24–142) months. Seven patients had left sided, nine had right sided, and eight had bilateral developmental dysplasia of the hip. All patients underwent closed reduction and Salter osteotomy. Preoperative and postoperative radiographs were assessed by measuring the center-edge (CE) angle of Wiberg, Smith’s c/b and h/b ratio, and acetabular index (AI). Patients were evaluated clinically according to McKay’s criteria and radiologically according to Severin criteria. The Kalamchi and MacEwen criteria were used in the evaluation of avascular necrosis. Results: The mean preoperative AI, CE angle, c/b, and h/b ratio were 36.7° (±4.1), 7.2° (±5.9), 0.9 (±0.08), and 0.05 (±0.04), respectively. The mean latest follow-up AI, CE angle, c/b, and h/b ratio were 18.2° (±1.7), 38.8° (±5.4), 0.6 (±0.03), and 0.19 (±0.04), respectively. The comparison of preoperative and postoperative radiological values revealed statistically significant improvement (p < 0.01). On the latest physical examinations of the patients, 25 (78.1%) hips were rated excellent, and 7 (21.9%) were rated good according to the McKay criteria. The Severin classification determined 25 (78.1%) hips were grade I and 7 (21.9%) hips were grade II. Type I avascular necrosis (AVN) was seen in four (12.5%) hips. Three of these four hips were more superolateral in preoperative radiographs (c/b > 1 and h/b < 0.05). Conclusions: Salter osteotomy without open reduction is a good surgery option for Tönnis type II hip dysplasia, in which closed reduction can be performed. However, the risk of AVN should be kept in mind in more superolateral type 2 hips.

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Section: Discussionmentioning

confidence: 78%

Salter osteotomy without open reduction in the Tönnis type II developmental hip dysplasia: A retrospective clinical study

Gürger

Demir

Yılmaz³

et al. 2019

J Orthop Surg (Hong Kong)

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“…In Zorer's study, twenty patients underwent a one-stage bilateral Pemberton's pericapsular osteotomy, and the results showed significant advantages over two separate consecutive interventions (20). Another study by (21). And only the blood transfusion volume was higher in one-stage bilateral Salter pelvic osteotomy group than that of unilateral osteotomy group (170 cc vs 100 cc), which may be because bilateral osteotomy group needs longer operation time.…”

Section: Discussionmentioning

confidence: 90%

Biomechanical investigation of pelvic stability in developmental dysplasia of the hip: unilateral salter osteotomy versus one-stage bilateral salter osteotomy

Yang

Song

et al. 2020

Preprint

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Background Developmental dysplasia of the hip (DDH) is a common disease in infants and children, and the treatment of bilateral DDH remains controversial. This study aimed to evaluate the stability of one-stage bilateral Salter pelvic osteotomy for bilateral DDH in patients of walking age. Methods In total, nine child cadavers aged 2–6 years were included. A universal mechanical testing machine was used for stability test. We performed two different surgical procedures on the specimens: nine child cadavers underwent unilateral Salter pelvic osteotomy, and six child cadavers were randomly selected to undergo Salter pelvic osteotomy again to simulate one-stage bilateral Salter pelvic osteotomy. The stability of the bilateral sacroiliac joints, local stability of the operation area, ultimate load test, and axial stiffness were evaluated. Results Both unilateral and bilateral Salter osteotomy could destroy the integrity of the pelvic ring and increase the risk of pelvic instability. In this study, compared with unilateral Salter osteotomy, bilateral Salter osteotomy had similar pelvic stability, and there was no significant difference between unilateral and bilateral Salter osteotomy in sacroiliac joint stability ( p > 0.05), local stability ( p = 0.763), ultimate load ( p = 0.328), and axial stiffness ( p = 0.480). Conclusions One-stage bilateral Salter pelvic osteotomy as a potential surgical method is viable and stable for children with bilateral DDH.

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“…In Zorer's study, 20 patients underwent a one-stage bilateral Pemberton's pericapsular osteotomy, and the results showed significant advantages over 2 separate consecutive interventions [20]. Another study by Agus' team evaluated the clinical outcome of 12 children (24 hips) who treated with one-stage bilateral Salter pelvic osteotomy and compared with 12 patients (12 hips) who received unilateral Salter pelvic osteotomy, and found one-stage bilateral Salter pelvic osteotomy did not increase the mortality and postoperative complications [21]. And only the blood transfusion volume was higher in one-stage bilateral Salter pelvic osteotomy group than that of unilateral osteotomy group (170 cc vs 100 cc), which may be because bilateral osteotomy group needs longer operation time.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical investigation of pelvic stability in developmental dysplasia of the hip: unilateral salter osteotomy versus one-stage bilateral salter osteotomy

Yang

Song

et al. 2020

J Orthop Surg Res

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Background: Developmental dysplasia of the hip (DDH) is a common disease in infants and children, and the treatment of bilateral DDH remains controversial. This study aimed to evaluate the stability of one-stage bilateral Salter pelvic osteotomy for bilateral DDH in patients of walking age. Methods: In total, nine child cadavers aged 2-6 years were included. A universal mechanical testing machine was used for stability test. We performed two different surgical procedures on the specimens: nine child cadavers underwent unilateral Salter pelvic osteotomy, and six child cadavers were randomly selected to undergo Salter pelvic osteotomy again to simulate one-stage bilateral Salter pelvic osteotomy. The stability of the bilateral sacroiliac joints, local stability of the operation area, ultimate load test, and axial stiffness were evaluated. Results: Both unilateral and bilateral Salter osteotomy could destroy the integrity of the pelvic ring and increase the risk of pelvic instability. In this study, compared with unilateral Salter osteotomy, bilateral Salter osteotomy had similar pelvic stability, and there was no significant difference between unilateral and bilateral Salter osteotomy in sacroiliac joint stability (p > 0.05), local stability (p = 0.763), ultimate load (p = 0.328), and axial stiffness (p = 0.480). Conclusions: One-stage bilateral Salter pelvic osteotomy as a potential surgical method is viable and stable for children with bilateral DDH.

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How are outcomes affected by performing a one-stage combined procedure simultaneously in bilateral developmental hip dysplasia?

Abstract: Simultaneous combined surgery is a challenging but worthwhile procedure for late diagnosed patients with bilateral DDH. The short-mid term outcomes of the procedure are encouraging.

Cited by 20 publications

References 20 publications

Salter osteotomy without open reduction in the Tönnis type II developmental hip dysplasia: A retrospective clinical study

Salter osteotomy without open reduction in the Tönnis type II developmental hip dysplasia: A retrospective clinical study

Biomechanical investigation of pelvic stability in developmental dysplasia of the hip: unilateral salter osteotomy versus one-stage bilateral salter osteotomy

Biomechanical investigation of pelvic stability in developmental dysplasia of the hip: unilateral salter osteotomy versus one-stage bilateral salter osteotomy

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