Rotational Acetabular Osteotomy for Advanced Osteoarthritis Secondary to Dysplasia of the Hip

Yasunaga, Yuji; Ochi, Mitsuo; Terayama, Hiroshi; Tanaka, Ryuji; Yamasaki, Takuma; Ishii, Yoshimasa

doi:10.2106/00004623-200709001-00008

Cited by 16 publications

(20 citation statements)

References 8 publications

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“…The anterior center-edge angle of Lequesne and de Seze (ACEA) was measured on the false profile radiograph [29,31,42,47,48]. All patients with radiographs available were reviewed and none was excluded.…”

Section: Methodsmentioning

confidence: 99%

“…The Tönnis classification of osteoarthritis was graded as 0 (no changes), 1 (widened sclerotic zone and minimal osteophyte formation), 2 (moderate loss of joint space and cyst formation), and 3 (\ 1 mm of joint space or no joint space). Joint congruency was graded according to Yasunaga as excellent (if the radii of curvature of the acetabulum and the femoral head were identical and joint space was maintained), good (curvature of femoral head and acetabulum not identical but with preserved joint space), fair (joint space partially narrowed), and poor (loss of joint space) [48]. There were 53 hips available for late postoperative radiographic review at a mean ± SD time of 17 ± 2 years from PAO.…”

Section: Methodsmentioning

confidence: 99%

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Survivorship of the Bernese Periacetabular Osteotomy: What Factors are Associated with Long-term Failure?

Wells

Millis

Kim

et al. 2017

Clinical Orthopaedics &Amp; Related Research

142

108

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Background The Bernese periacetabular osteotomy (PAO) continues to be a commonly performed nonarthroplasty option to treat symptomatic developmental hip dysplasia, but there are few long-term followup studies evaluating results after PAO. Questions/purposes (1) What is the long-term survivorship of the hip after PAO? (2) What were the validated outcomes scores among patients who had PAO more than 14 years ago? (3) What factors are associated with longterm failure? Methods One hundred fifty-eight dysplastic hips (133 patients) underwent PAO between May 1991 and September 1998 by a single surgeon. Of those, 37 hips (34 patients [26%]) were lost to followup; an additional seven patients (5% [eight hips]) had not been seen in the last 5 years. The 121 hips (in 99 patients) were retrospectively evaluated at a mean of 18 years (range, 14-22 years).Survivorship was assessed using Kaplan-Meier analysis with total hip arthroplasty (THA) as the endpoint. Hips were evaluated for activity, pain, and general health using the UCLA Activity Score, modified Harris hip score, WOMAC, and Hip disability and Osteoarthritis Outcome Score (HOOS). Failure was defined as a WOMAC pain subscale score C 10 or having undergone THA. Hips were divided into three groups: asymptomatic (did not meet any failure criteria at any point in time), symptomatic (met WOMAC pain failure criteria at previous or most recent followup), and replaced (having undergone THA). A multinomial logistic regression model using a general estimating equations approach was used to assess factors associated with failure.Results Kaplan-Meier analysis with THA as the endpoint revealed a survival rate (95% confidence interval [CI]) of 74% (66%-83%) at 18 years. Twenty-six hips (21%) underwent THA at an average of 9 ± 5 years from the surgery. Sixty-four hips (53%) remained asymptomatic and did not meet any failure criteria at most recent followup. Thirty-one hips (26%) were symptomatic and considered failed based on a WOMAC pain score of C 10 with a mean ± SD of 11 ± 4 out of 20 at most recent followup. Although some failed initially by pain, their most recent WOMAC score may have been \ 10. Of the 16 symptomatic hips that failed early by pain (reported a WOMAC pain subscale score C 10 in the prior study), two were lost to followup, two underwent THA at 16 and 17 years, four still failed because of pain at most recent followup, and the remaining eight had WOMAC pain scores \ 10 at most recent followup. Asymptomatic hips reported better UCLA Activity Scores (asymptomatic: mean ± SD, 7 ± 2; symptomatic: 6 ± 2, p = 0.001), modified Harris hip scores (pain, function, and activity sections; asymptomatic: 80 ± 11; symptomatic: 50 ± 15, p \ 0.001), WOMAC Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Intere...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Survivorship of the Bernese Periacetabular Osteotomy: What Factors are Associated with Long-term Failure?

Wells

Millis

Kim

et al. 2017

Clinical Orthopaedics &Amp; Related Research

142

108

View full text Add to dashboard Cite

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“…In a number of studies [2,3,7,27,28,47,56,57], an abduction and internal rotation radiograph was used to determine if the femoral head would roll into the acetabulum and obtain the expected congruity after surgery. The indications for surgery for RAO were similar to PAO [10,15,16,20,21,26,35,39,42,53,54,61,[63][64][65] (Table 1).…”

Section: Search Strategy and Criteriamentioning

confidence: 83%

“…Siebenrock et al [50] suggested the factors that mitigate against a good clinical score of Merle d'Aubigné score ([ 15 points) and prevention of OA progression after a PAO were advanced stage and older age at the time of surgery. Recent studies [16,43,64] reported that properly selected patients with advanced-stage OA could have a good clinical score ([ 80 points of Harris hip score or [ 15 points of Merle d'Aubigne score) after RAO. Yasunaga et al [64] proposed the essential criteria for advanced-stage OA were a good postoperative joint congruency expected and a preoperative minimum joint space width of [ 2.2 mm.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Recent studies [16,43,64] reported that properly selected patients with advanced-stage OA could have a good clinical score ([ 80 points of Harris hip score or [ 15 points of Merle d'Aubigne score) after RAO. Yasunaga et al [64] proposed the essential criteria for advanced-stage OA were a good postoperative joint congruency expected and a preoperative minimum joint space width of [ 2.2 mm. Hasegawa et al [16] also noticed preoperative joint space wider than 2 mm was essential for cases with advanced stage.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

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Patient Selection Criteria for Periacetabular Osteotomy or Rotational Acetabular Osteotomy

Yasunaga

Yamasaki

Ochi

2012

Clinical Orthopaedics &Amp; Related Research

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Background Hip dysplasia is the most common cause of secondary osteoarthritis (OA). Periacetabular osteotomy (PAO) or rotational acetabular osteotomy (RAO) has been used as a joint-preserving procedure. However, the patient selection criteria are not clearly defined. Questions/purposes Based on a systematic review, we identified reported patient selection criteria for PAO or RAO. Methods We performed a systematic review of RAO and 18 studies met our inclusion criteria. For the PAO, the systemic review performed by Clohisy et al. was used. Where Are We Now? For patients with symptomatic hip dysplasia, lateral center-edge angle less than 10°to 30°, radiographic pre-or early OA, mean age at the time of surgery of 18 to 45 years, and improvement in joint congruency on AP radiograph with hip abduction, radiographic deformity correction consistently improved hip function in all studies. Radiographic OA progression was noted in 5% to 33% at 3.2 to 20 years postoperatively. Clinical score and prevention of radiographic OA progression of patients 50 years or older or with advanced stage were worse in younger patients or those with early stage. Where Do We Need to Go? The key challenges are (1) preoperative evaluation of articular cartilage; (2) indication for older patients; (3) prevention of secondary femoroacetabular impingement; and (4) intraarticular treatment combined with PAO or RAO. How Do We Get There? Future prospective, longitudinal cohort studies need to determine optimal patient selection criteria, risk factors for clinical failure, optimal deformity correction parameters, and the role of adjunctive surgical procedures.

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Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip

Janssen¹,

Kalchschmidt

Katthagen

2009

International Orthopaedics (SICOT)

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Joint-preserving osteotomies are an established treatment for adult hip pain secondary to developmental dysplasia of the hip. However, their value for advanced osteoarthritis is unclear. Therefore this study addresses the question of long-term results of triple pelvic osteotomy in patients with second grade osteoarthritis. Thirty-two patients with second grade osteoarthritis secondary to developmental dysplasia of the hip before triple pelvic osteotomy were clinically and radiographically assessed 11.5 years postoperatively. Five patients required conversion to total hip replacement. Kaplan-Meier survivorship analysis predicted a survival rate of 85.3%. The mean Harris hip score increased significantly with more than 56% good or very good results. A preoperative BMI > 25 and Harris hip score < 70 resulted in worse outcome or early conversion into total hip arthroplasty. The results indicate that developmental dysplasia of the hip even in second grade osteoarthritis can be treated with triple pelvic osteotomy.

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Rotational Acetabular Osteotomy for Advanced Osteoarthritis Secondary to Dysplasia of the Hip

Cited by 16 publications

References 8 publications

Survivorship of the Bernese Periacetabular Osteotomy: What Factors are Associated with Long-term Failure?

Survivorship of the Bernese Periacetabular Osteotomy: What Factors are Associated with Long-term Failure?

Patient Selection Criteria for Periacetabular Osteotomy or Rotational Acetabular Osteotomy

Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip

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