Indications for Intertrochanteric Osteotomy After Periacetabular Osteotomy for Adult Hip Dysplasia

Hersche, Otmar; Casillas, Mark M.; Ganz, Reinhold

doi:10.1097/00003086-199802000-00004

Cited by 27 publications

(26 citation statements)

References 6 publications

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“…The Bernese PAO has been established as an effective surgical technique for the correction of acetabular deformities [2,5,7,14,17,19,20,[23][24][25][26]28], yet in severely dysplastic hips, optimal reconstruction may require an adjunctive proximal femoral osteotomy [11]. Nevertheless, the documented clinical results of combined PAO/PFO are limited and, to our knowledge, there are no studies focused on this combination of procedures.…”

Section: Discussionmentioning

confidence: 99%

“…In severely deformed hips, some authors suggest adjunctive PFO may help to correct the deformities or enhance hip congruency, stability, and function [5,7,11]. Although several reports include a subpopulation of patients treated with combined PAO and PFO, we are unaware of any study exclusively reporting the clinical outcomes of this type of reconstruction [5,7,11,26,28]. With respect to surgical indications for the PFO, Hersche and colleagues [11] retrospectively analyzed radiographic parameters that were associated with the need to perform this adjunctive procedure.…”

Section: Introductionmentioning

confidence: 99%

“…Although several reports include a subpopulation of patients treated with combined PAO and PFO, we are unaware of any study exclusively reporting the clinical outcomes of this type of reconstruction [5,7,11,26,28]. With respect to surgical indications for the PFO, Hersche and colleagues [11] retrospectively analyzed radiographic parameters that were associated with the need to perform this adjunctive procedure. They identified several variables that had an association with the performance of PFO.…”

Section: Introductionmentioning

confidence: 99%

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Combined Periacetabular and Femoral Osteotomies for Severe Hip Deformities

Clohisy

John

Nunley

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Periacetabular osteotomy (PAO) is an effective acetabular reorientation technique for treatment of symptomatic acetabular dysplasia. In hips with severe deformities, an adjunctive femoral osteotomy (PFO) may optimize correction, joint stability, and congruency. We analyzed the clinical and radiographic results of combined PAO/PFO in treating severe hip deformities. Second, we compared the clinical results of patients treated with PAO/ PFO with patients treated with isolated PAO for lesser deformities. Twenty-five patients (28 hips) treated with PAO/PFO were reviewed and followed a minimum of 16 months (mean, 44 months). The matched PAO cohort included 25 patients (28 hips). For the PAO/PFO group, the average Harris hip score improved from 60.9 to 86.3. Eighty-nine percent of the patients demonstrated at least a 10-point improvement in the hip score and 75% had a Harris hip score over 80 points. Radiographic evaluation demonstrated consistent deformity correction. The PAO/ PFO group had a lower average Harris hip score preoperatively, yet hip function after surgery was comparable between groups. These data indicate combined PAO/ PFO is associated with improved hip function in most patients. These clinical results are comparable to those obtained with isolated PAO for lesser hip deformities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Combined Periacetabular and Femoral Osteotomies for Severe Hip Deformities

Clohisy

John

Nunley

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…A prior study [12] retrospectively analyzed which clinical and radiographic variables in hips undergoing a PAO were associated with an additional ITO. The femoral head extrusion index after PAO was found to be 7% when a valgus ITO was performed, 30% when a varus ITO was performed and 13% when an isolated PAO was performed.…”

Section: Introductionmentioning

confidence: 99%

“…A discriminate analysis predicted the actual treatment (PAO with PFO or PAO alone) in 89% of the cases. However, this study [12] was published prior to the introduction of more recent PFOs such as femoral neck osteotomy (FNO), relative femoral neck lengthening (RFNL) and femoral head reduction osteotomy (FHRO), which have further widened the spectrum of indications for performing a PFO [7].…”

Section: Introductionmentioning

confidence: 99%