Long-term outcomes of shelf acetabuloplasty for developmental dysplasia of the hip in adults: a minimum 20-year follow-up study

Abstract

BackgroundShelf acetabuloplasty has been applied to secondary osteoarthritis of the hip due to congenital dislocation or acetabular dysplasia; however, there are few reports on the long-term outcomes of this operation. Here, we aimed to investigate the long-term effects of our shelf acetabuloplasty for developmental dysplasia of the hip in adults.MethodsOutcomes for 28 hips (7 with pre-arthrosis, 21 with initial stage of arthrosis) were retrospectively reviewed clinically and radiologically at a minimum of 20 years after operation. Mean age of the patients at operation was 34 years (range 17–54 years), and the mean follow-up period was 25 years (range 20–32 years).ResultsMean Japanese Orthopaedic Association hip score improved from 76 points preoperatively to 82 points, and mean pain score improved from 24 points preoperatively to 33 points at 20 years. Mean Sharp angle improved from 51° preoperatively to 37° immediately after the operation. Similarly, the mean center-edge angle improved from −4° to 38°, and the mean acetabulum head index improved from 52 to 99%. More than 50% of the hips showed no change in joint space width at 20 years. Survival rates were 100% at 10 years, 93% at 20 years and 71% at 32 years, with conversion to total hip replacement as the endpoint.ConclusionLong-term outcomes of our shelf acetabuloplasty were comparable to other reports, and the clinical outcomes and survivorship revealed positive long-term effects of our procedure over approximately 20 years.

Long-term outcomes of the hip shelf arthroplasty in adolescents and adults with residual hip dysplasia: a systematic review

“…Kaplan-Meier survival analysis with THA as endpoint ( Figure 2) was documented by 5 studies (Migaud et al 2004, Fawzy et al 2005, Berton et al 2010, Hirose et al 2011, Tanaka et al 2018. Fawzy et al (2005) analyzed 76 hips from 67 patients with an average age of 33.…”

Total Hip Arthroplasty after Previous Acetabular Osteotomy: Comparison of Three Types of Acetabular Osteotomy

“…Various types of periacetabular osteotomy have been performed for adolescents and adults with developmental dysplasia, and good longterm results have been reported [4][5][6][7][8][9]. There are 3 important requirements for the success of joint-preserving surgery [10]: creation of a larger articular surface, preservation of muscle strength, and creation of a favorable condition for THA at a later stage.…”

“…Various types of acetabular osteotomies have been performed to delay progression of osteoarthritis or treat early osteoarthritis in adolescents and young adults; furthermore, many satisfactory long-term results have been reported [4][5][6][7][8][9]. However, some patients must undergo conversion arthroplasty because of continued pain or progression of hip arthritis after osteotomy [7,10].…”

Less invasive modified Spitzy shelf procedure for patients with dysplasia of the hip

“…The principle shelf procedure for DDH was originally described by Konig in 1891 [7] and seems to be a safer and simpler technique compared with periarticular acetabular osteotomies. Furthermore, several studies on the long-term results of shelf procedures have reported highly encouraging survival rates [8][9][10][11]. However, the most commonly used approach for the shelf procedure, the Smith-Peterson approach, exposes a large section of the iliac crest via a long skin incision and is relatively invasive.…”