Results of Tönnis-type acetabuloplasty in patients with developmental hip dysplasia

Günel, Uğur; Dağlar, Bülent; Taşbaş, Bülent A.; Delialioglu, Onder M.; Bayrakçı, Kenan

doi:10.1007/s00776-012-0287-8

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…López-Carreño et al [12] showed that the Dega osteotomy had better functional results and AI improvement than Salter osteotomy. Also, Gunel et al [20] reported that the mean AI improved from 451 preoperatively to 181 at follow-up. Ertürk and colleagues compared radiological results of Pemberton reshaping osteotomy and Salter osteotomy.…”

Section: Discussionmentioning

confidence: 96%

Radiological results of modified Dega osteotomy in Tönnis grade 3 and 4 developmental dysplasia of the hip

Akgül

Göksan

Bilgili

et al. 2014

Journal of Pediatric Orthopaedics B

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Dega acetabuloplasty at the time of open reduction is effective in improving the acetabular coverage of the femoral head, hence improving the stability of reduction and preventing possible surgery in the future for residual acetabular dysplasia in older children with Tönnis grade 3 and 4 developmental dysplasia of the hip (DDH). The aim of this study was to assess the radiological results of open reduction combined with Dega osteotomy in DDH. Twenty-two children's 26 hips were operated on at a mean age of 38±20.4 SD months and followed up for an average of 42 (range 24-108) months. Thirteen hips (50%) were operated on with concomitant open reduction and capsulorrhaphy, and 13 hips (50%) were treated with concomitant open reduction, capsulorrhaphy and femoral shortening osteotomy. Radiological examination included acetabular index (AI) and centre edge angle measurements. The mean preoperative AI was 39.4±6.9° SD, which improved to 18.3±4.5° SD postoperatively, and AI was measured as 15±3.5° SD at the latest follow-up. There was a significant difference in the mean AI values between the last follow-up and the preoperative measurements (P<0.05). The mean centre edge angle was 31±5.6° SD postoperatively, and it was 31±6.2° SD at follow-up. There was no significant difference between the two values. Two hips were noted to have lateralization of the femoral head due to coxa valga anteverta. One of them was operated with a femoral varus osteotomy. The Dega osteotomy combined with anterior open reduction and femoral osteotomies is a safe and effective acetabular osteotomy for surgical treatment of severe DDH such as Tönnis grade 3 and 4 dislocations.

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Section: Discussionmentioning

confidence: 96%

Radiological results of modified Dega osteotomy in Tönnis grade 3 and 4 developmental dysplasia of the hip

Akgül

Göksan

Bilgili

et al. 2014

Journal of Pediatric Orthopaedics B

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“…Gunel et al performed an open reduction with acetabuloplasty without femoral osteotomy in 24 of their 32 cases of hip dislocation. The age of the patients was between 12 and 44 months [6].…”

Section: Discussionmentioning

confidence: 99%

“…While most cases of hip dislocation can be easily treated in infancy using a retention therapy, such as a plaster cast or a Pavlik harness, more extensive measures are needed for children of walking age. Children of walking age are treated through open reduction, possibly with acetabuloplasty, with or without femoral osteotomy [3][4][5][6][7]. The necessity of and the type of femoral osteotomy are controversially debated [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic reduction and acetabuloplasty for the treatment of dislocated hips in children of walking age: a preliminary report

Eberhardt

Wirth

Fernández

2014

Arch Orthop Trauma Surg

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We can conclude that the standardized arthroscopic surgical technique presented here can also be used to safely perform arthroscopic reduction in toddlers. The new arthroscopic method is an alternative to open reduction for selective hip dislocations. We believe this approach can be used to treat dislocated hips that are classified as grades 2 and 3 dislocations according Tönnis. Early results are promising. Medium-term results are needed to make a definitive statement on the rates of necrosis of the femoral head.

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“…Open reduction, sometimes combined with acetabuloplasty and femoral osteotomy, remains the standard treatment after failed closed reduction [ 3 – 6 ]. However, serious complications [ 7 , 8 ], including avascular necrosis of the femoral head, may occur following open reduction and negatively affect patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Medium-term results following arthroscopic reduction in walking-age children with developmental hip dysplasia after failed closed reduction

et al. 2017

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BackgroundArthroscopic reduction has become increasingly popular as an alternative to open reduction for the treatment of developmental dysplasia of the hip (DDH). However, patient outcomes beyond one and a half years after surgery remain unclear. The purpose of this study is to report the medium-term outcomes of walking-age patients who received arthroscopic reduction after an unsuccessful closed reduction. This research was conducted as part of a retrospectively registered study.MethodsWe performed arthroscopic reduction in eight children with DDH after failed closed reduction between January 2010 and January 2012 and followed all cases for a minimum of 5 years. Arthroscopic reduction was performed using a two-portal approach without traction. Capsular release and resection of the transverse acetabular ligament were also performed if needed. Patient demographics, clinical variables, anatomical assessment measures, and post-operative complications were extracted from medical records.ResultsWe treated five male and three female patients with an average age at operation of 15.6 months (range, 12 to 22 months). All obstacles to reduction were corrected arthroscopically. Concentric reduction of the hip joint was observed in post-operative X-rays in all cases. The average safe zone was increased from 17.5° (8° to 30°) to 42.1° (36° to 50°) after the operation. The average acetabular (AC) index was reduced from 40.3° (33° to 65°) to 21.9° (19° to 26°) at the end of follow-up. No complications occurred and no patients developed necrosis of the femoral head, recurrent dislocation, or residual hip dysplasia.ConclusionsArthroscopic reduction is a suitable surgical procedure for the treatment of DDH among walking-age children with failed closed reduction and severe dislocation. This method is quick and safe, and it can be performed without post-operative complications over the medium term.

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Results of Tönnis-type acetabuloplasty in patients with developmental hip dysplasia

Cited by 9 publications

References 19 publications

Radiological results of modified Dega osteotomy in Tönnis grade 3 and 4 developmental dysplasia of the hip

Radiological results of modified Dega osteotomy in Tönnis grade 3 and 4 developmental dysplasia of the hip

Arthroscopic reduction and acetabuloplasty for the treatment of dislocated hips in children of walking age: a preliminary report

Medium-term results following arthroscopic reduction in walking-age children with developmental hip dysplasia after failed closed reduction

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