Osteotomía periacetabular en el tratamiento de displasia de cadera mediante técnica mini-invasiva. Nuestros resultados a medio plazo en 131 casos

Ramírez-Núñez, L.; Comas, Manuel R.; Cardenas, Carlomagno; Bellotti, Vittorio; Astarita, Emanuele; Chacón-Cascio, G.

doi:10.1016/j.recot.2020.01.003

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Вероятно, в ближайшем будущем мы также внесем некоторые усовершенствования в методику ПАО, полагаясь на собственный опыт, однако, по нашему мнению, классическая хирургическая техника ПАО показывает стабильные хорошие результаты. группой ученых под руководством L. Ramirez-Nunez были изучены результаты лечения 131 пациента с дисплазией ТБС, которым была выполнена ПАО по мини-инвазивной технике, описанной A. Troelsen, со средним сроком наблюдения 7,7±2,8 лет [3]. Средний возраст пациентов составил 32,3±9,5 лет, 77,9% пациентов являлись женщинами.…”

Section: хирургическая техникаunclassified

“…Дисплазия тазобедренного сустава (ТБС) -особенность развития, сопровождающаяся недостаточным покрытием вертлужной впадиной головки бедренной кости, что приводит к увеличению риска развития вторичных дегенеративных изменений в суставе и в конечном итоге к коксартрозу [1,2]. При отсутствии тяжелых признаков дегенеративных изменений в суставе для молодых пациентов все чаще методом лечения дисплазии становятся остеотомии таза [3,4]. Остеотомии таза предназначены для восстановления нормальной анатомии и биомеханики: увеличения площади контакта головки бедренной кости, уменьшения контактного напряжения, нормализации веса несущих сил и, как следствие, предотвращения дегенеративных изменений ТБС [2].…”

Section: Introductionunclassified

“…Остеотомии таза предназначены для восстановления нормальной анатомии и биомеханики: увеличения площади контакта головки бедренной кости, уменьшения контактного напряжения, нормализации веса несущих сил и, как следствие, предотвращения дегенеративных изменений ТБС [2]. В последние десятилетия именно периацетабулярная остеотомия (ПАО) таза по Ganz является наиболее популярной по всему миру в лечении дисплазии и в настоящее время признана «золотым стандартом» у взрослых пациентов [3,5]. ПАО позволяет осуществить переориентацию вертлужной впадины, что способствует сбалансированному распределению нагрузок на головку бедренной кости, лучшему покрытию головки бедра вертлужной впадиной, поддержанию контакта гиалинового хряща вертлужной впадины и головки бедренной кости [6].…”

Section: Introductionunclassified

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Periacetabular Pelvic Osteotomy in Treatment of Patients with Developmental Dysplasia of the Hip

Корыткин

А²,

Novikova

et al. 2021

Traumatology and Orthopedics of Russia

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Background. Pelvic osteotomies are widely used for treatment of young active patients with developmental dysplasia of the hip (DDH) Type I according to the Crowe or type A according to Hartofilakidis classifications and the absence of severe degenerative cartilage lesions. Nowadays, Ganz periacetabular osteotomy (PAO) is the most common choice of surgeons around the world in treatment of such patients.The aim of the study was to evaluate the radiological and functional results of Ganz periacetabular osteotomy in patients with DDH.Material and Methods. A single-center retrospective analysis of 49 Ganz PAO was performed in 43 patients aged 36±9 years. The radiological evaluation criteria were Wiberg (AW), Lequesne (AL), Tonnis (AT) angles, and joint medialization. The results of treatment were evaluated using the Harris scale, iHOT-12, and VAS before treatment and 1 year after, the presence of complications was also monitored.Results. The average follow-up period was 35±15 months (from 1.0 to 6.9 years). Radiological parameters improved after surgery compared to preoperative ones: AW +19.9° (17.1° vs. 37.0°), AT -11.5° (19.9° vs. 8.4°), AL +14.1° (25.1° vs. 39.2°), joint medialization -5.5 mm (14.3 mm vs. 8.8 mm) (p<0.001). Functional results and quality of life of patients also improved: the Harris scale +35.6 points (47 vs 83 points), iHOT-12 +40.9 points (44 vs 85 points), pain level -2.8 points (5 vs 2 points) (p<0.001). Various complications developed in 20 out of 49 cases (40.8%). Neurological complications were resolved conservatively (22.4%). A direct correlation was evaluated between the surgical treatment of DDH in childhood and the development of neurological complications after PAO (R = 0.76; p<0.001). In 9 cases out of 49 (18.4%), revision surgery was required: in 3 — total hip replacement, in 2 — reorientation of the acetabulum, in 4 — arthroscopic fixation of the anterior articular lip. In 93.9% of cases native hip joint surfaces were preserved.Conclusion. Ganz PAO has good reconstructive capabilities and sufficient efficiency. The operation allows to restore the coverage of the femoral head with the acetabulum, delays total hip replacement and provides improved functional results.

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Section: хирургическая техникаunclassified

Section: Introductionunclassified

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Periacetabular Pelvic Osteotomy in Treatment of Patients with Developmental Dysplasia of the Hip

Корыткин

А²,

Novikova

et al. 2021

Traumatology and Orthopedics of Russia

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Functional and radiological outcomes of periacetabular osteotomy for hip dysplasia in patients under fifty years using a minimally invasive approach—a single surgeon series with a minimum follow up of two years

Sunil Kumar,

Bhargava,

Stamp

et al. 2024

International Orthopaedics (SICOT)

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Purpose We conducted a retrospective analysis of prospectively collected data to evaluate (1) the extent of surgical correction following minimally invasive periacetabular osteotomy, (2) improvements in functional outcomes and any potential predictors for favourable outcome, and (3) complications after minimally invasive periacetabular osteotomy. Methods A total of 352 minimally invasive periacetabular osteotomy procedures were performed on 312 hip dysplasia patients between 2013 and 2020. Radiological parameters such as lateral centre edge angle, acetabular index, and Tönnis grade of arthritis were calculated. Patients also completed a range of patient reported outcome measures. Wilcoxon signed-rank tests were performed to assess for differences between patient reported outcome measures and radiological outcomes across the follow-up periods. Univariate linear regression and logistic regression were used to assess for predictors of change in functional outcome. Results Patients had a significant correction in mean lateral centre edge angle from 17.2° to 35.3° (p < 0.001) and mean acetabular index from 13.2° to − 0.82°. At one year follow-up all patient reported outcome measures were significantly greater than their baseline measurements and this improvement was maintained at two years. Changes in patient reported outcome measures were independent of radiological parameters such as change in the lateral centre edge angle and acetabular index, pre-operative Tönnis grade, and patient factors such as age and sex. A total of 5.11% of patients developed post-operative complications, with four requiring posterior column fixation. Four patients (1.12%) needed a total hip replacement. Conclusion Minimally invasive periacetabular osteotomy is a safe procedure that provides significant functional outcome improvements following surgery at six months which is maintained at two years. More than three-fourths of patients achieved improvement of iHOT-12 score beyond the minimal clinically important difference and more than half of the patients achieved substantial clinical benefit for iHOT-12 score.

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Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis

O’Brien,

Semciw,

Mechlenburg

et al. 2023

HIP International

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Background: Hip dysplasia is a common condition in active adults with hip pain that can lead to joint degeneration. Periacetabular osteotomy (PAO) is a common surgical treatment for hip dysplasia. The effect of this surgery on pain, function and quality of life (QOL) has not been systematically analysed. Purpose: In adults with hip dysplasia: (1) evaluate differences in pain, function and QOL in those undergoing PAO and healthy controls; (2) evaluate pre- to post-PAO changes in pain, function and QOL; (3) evaluate differences in pain, function and QOL in those with mild versus severe dysplasia, undergoing PAO; and (4) evaluate differences in pain, function and QOL in those having primary PAO versus those with previous hip arthroscopy. Methods: A comprehensive, reproducible search strategy was performed on 5 different databases. We included studies that assessed pain, function and QOL in adults undergoing PAO for hip dysplasia, using hip-specific patient reported outcomes measures. Results: From 5017 titles and abstracts screened, 62 studies were included. Meta-analysis showed PAO patients had worse outcomes pre- and post-PAO compared to healthy participants. Specifically, pain (standardised mean difference [SMD] 95% confidence interval [CI]): −4.05; −4.78 to −3.32), function (−2.81; −3.89 to −1.74), and QOL (−4.10; −4.43 to −3.77) were significantly poorer preoperatively. Meta-analysis found patients experienced improvements following PAO. Pain improved from pre-surgery to 1-year (standardised paired difference [SPD] 1.35; 95% CI, 1.02–1.67) and 2 years postoperatively (1.35; 1.16–1.54). For function, the activities of daily living scores at 1 year (1.22; 1.09–1.35) and 2 years (1.06; 0.9–1.22) and QOL at 1 year (1.36; 1.22–1.5) and 2 years (1.3; 1.1–1.5) all improved. No difference was found between patients undergoing PAO with mild versus severe dysplasia. Conclusions: Before undergoing PAO surgery, adults with hip dysplasia have worse levels of pain, function and QOL compared to healthy participants. These levels improve following PAO, but do not reach the same level as their healthy participants. Registration: PROSPERO (CRD42020144748)

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Osteotomía periacetabular en el tratamiento de displasia de cadera mediante técnica mini-invasiva. Nuestros resultados a medio plazo en 131 casos

Cited by 3 publications

References 21 publications

Periacetabular Pelvic Osteotomy in Treatment of Patients with Developmental Dysplasia of the Hip

Periacetabular Pelvic Osteotomy in Treatment of Patients with Developmental Dysplasia of the Hip

Functional and radiological outcomes of periacetabular osteotomy for hip dysplasia in patients under fifty years using a minimally invasive approach—a single surgeon series with a minimum follow up of two years

Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis

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