Influence of shelf acetabuloplasty on the outcomes of total hip arthroplasty in hips with dysplasia: a case–control study

Benad, K.; Martinot, Pierre; Dartus, Julien; Girard, Julien; Putman, Sophie; Migaud, Henri

doi:10.1007/s00264-022-05322-3

Cited by 3 publications

(4 citation statements)

References 40 publications

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“…34-36 In contrast, a shelf operation does not affect the shape of the pelvic ring and only rarely interferes with future THA, if needed. 22,37,38 However, shelf operations are unable to improve the coverage of the femoral head with true acetabular articular cartilage, and they are limited in their ability to correct the mechanical environment of the hip. We assessed the mid-term durability of our modified Spitzy shelf acetabuloplasty and analyzed the risk factors for radiological OA progression.…”

Section: Discussionmentioning

confidence: 99%

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The modified Spitzy shelf acetabuloplasty for the dysplastic hip

Oe,

Iida,

Otsuki

et al. 2023

Bone Jt Open

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AimsAlthough there are various pelvic osteotomies for acetabular dysplasia of the hip, shelf operations offer effective and minimally invasive osteotomy. Our study aimed to assess outcomes following modified Spitzy shelf acetabuloplasty.MethodsBetween November 2000 and December 2016, we retrospectively evaluated 144 consecutive hip procedures in 122 patients a minimum of five years after undergoing modified Spitzy shelf acetabuloplasty for acetabular dysplasia including osteoarthritis (OA). Our follow-up rate was 92%. The mean age at time of surgery was 37 years (13 to 58), with a mean follow-up of 11 years (5 to 21). Advanced OA (Tönnis grade ≥ 2) was present preoperatively in 16 hips (11%). The preoperative lateral centre-edge angle ranged from -28° to 25°. Survival was determined by Kaplan-Meier analysis, using conversions to total hip arthroplasty as the endpoint. Risk factors for joint space narrowing less than 2 mm were analyzed using a Cox proportional hazards model.ResultsThe mean Merle d'Aubigné clinical score improved from 11.6 points (6 to 17) preoperatively to 15.9 points (12 to 18) at the last follow-up. The survival rates were 95% (95% confidence interval (CI) 91 to 99) and 86% (95% CI 50 to 97) at ten and 15 years. Multivariate Cox regression identified three factors associated with radiological OA progression: age (hazard ratio (HR) 2.85, 95% CI 1.05 to 7.76; p = 0.0398), preoperative joint space (HR 2.41, 95% CI 1.35 to 4.29; p = 0.0029), and preoperative OA (HR 8.34, 95% CI 0.94 to 73.77; p = 0.0466).ConclusionModified Spitzy shelf acetabuloplasty is an effective joint-preserving surgery with a wide range of potential indications.Cite this article: Bone Jt Open 2023;4(12):932–941.

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Section: Discussionmentioning

confidence: 99%

“…[34][35][36] In contrast, a shelf operation does not affect the shape of the pelvic ring and only rarely interferes with future THA, if needed. 22,37,38 However, shelf operations are unable to improve the coverage of the femoral head with true acetabular articular cartilage, and they LCEA, lateral centre-edge angle; N/A, not applicable.…”

Section: Discussionmentioning

confidence: 99%

The modified Spitzy shelf acetabuloplasty for the dysplastic hip

Oe,

Iida,

Otsuki

et al. 2023

Bone Jt Open

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“…Shelf operation is a salvage operation, which is suitable for older children who have failed nonoperative treatment of DDH[ 84 ]. Shelf acetabuloplasty has a favorable, stimulatory effect on acetabular growth[ 85 ]. The operation does not change the direction or biomechanical structure of the acetabulum, but increases the volume, so it can improve stability of the hip joint.…”

Section: Salvage Pelvic Osteotomiesmentioning

confidence: 99%

Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children

Wang¹,

Wu²,

Kuang³

et al. 2023

World J Orthop

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Developmental dysplasia of hip seriously affects the health of children, and pelvic osteotomy is an important part of surgical treatment. Improving the shape of the acetabulum, preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies. Re-directional osteotomies, reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy. The influence of different pelvic osteotomy on acetabular morphology is different, and the acetabular morphology after osteotomy is closely related to the prognosis of the patients. But there lacks comparison of acetabular morphology between different pelvic osteotomies, on the basis of retrospective analysis and measurable imaging indicators, this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.

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“…Patients at risk are women over 30 years of age with stage 2 osteoarthritis (80% survival before 30 years / 64% after 30 years; moderate evidence, P-value 0.15). Shelf acetabuloplasty does not exclude the placement of a total hip replacement later on under the right conditions 28 . Shelf acetabuloplasty even allows coverage of the prosthetic cup of a hip that was initially dysplastic.…”

Section: Highlights Of the Studymentioning

confidence: 99%

Is minimally invasive shelf acetabuloplasty in adults more reliable than periacetabular osteotomy? Long- term results

Chiron

2022

MRAJ

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This is a retrospective, single-operator study which hypothesised that shelf acetabuloplasty for acetabular dysplasia with a centre-edge angle of Wiberg between 0° and 15° and stage 1 or 2 osteoarthritis, has comparable results to periacetabular osteotomy with less severe complications. Patients and methods: 95 hips, mean follow-up of 12.8 years (4-26.4), 70.5% female (67/95), 29.5% male (28/95), mean age of 34.7 years (16-61 years). The surgical technique was minimally invasive, intermuscular between the posterior border of the tensor facia lata muscle and the anterior border of the gluteus medius muscle as described by Chiron in 2007. Survival curves were analysed using the Kaplan Meier method with the Log Rank test; Cox power test: 0.832. Results: Complications: 4 graft lyses (4.2%); 3 non-unions (3.1%); 56.8% (54/95) screw removal; no infection, no lateral femoral cutaneous nerve injury, all low-grade complications with no high-grade. Total hip replacements: 22.1% (21/95) of which 52.3% (11/21) were in the first 5 years. Age and gender had a significant impact on survival: under 30 years, 13.9% (6/43); over 30 years, 30% (15/50); under 25 years, 0% (0/13; mean follow-up 14.6 years; 9 -26); females, 26.8% (18/67), males, 10.7% (3/28). Survival: Overall (5 years: 90%, 10 years: 83,5%, 15 years: 77%); according to age: under 30 years (5 years: 95,3%, 10 years: 88,8%, 15 years: 84,3%), over 30 years (5 years: 84%, 10 years: 77,4%, 15 years: 69%), P-value 0.0004; according to gender: females (5 years: 86,3%, 10 years: 77,4%, 15 years: 68,9%), males (5 years: 96%, 10 years: 92,1%, 15 years: 92,1%), p-value: 0,0826; females over 30 years (5 years: 80,4%, 10 years: 75,1%, 15 years: 64,4%), females under 30 years (5 years: 91,6%, 10 years: 87,3%, 15 years: 80%), P-value: 0,1502 Survival rates were similar to those for peri acetabular arthroplasty, with no serious complications. Checking for any associated labral hip tears and arthroscopic treatment beforehand should improve the total hip replacement rate in the first 5 years. Ideal patients are young males and those at risk are females over 30 years of age, but with results that are still acceptable for group at risk which justify this minimally invasive procedure

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Influence of shelf acetabuloplasty on the outcomes of total hip arthroplasty in hips with dysplasia: a case–control study

Cited by 3 publications

References 40 publications

The modified Spitzy shelf acetabuloplasty for the dysplastic hip

The modified Spitzy shelf acetabuloplasty for the dysplastic hip

Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children

Is minimally invasive shelf acetabuloplasty in adults more reliable than periacetabular osteotomy? Long- term results

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