Salter Innominate Osteotomy in the Treatment of Severe Legg-Calvé-Perthes Disease

Ishida, Akira; Kuwajima, Sérgio S; Filho, José Laredo; Milani, Carlo

doi:10.1097/01241398-200405000-00004

Cited by 31 publications

(3 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, 29 of 37 hips (78.4%) in a study by Ishida et al . were classified accordingly [ 10 ]. Similar results were found in other studies [ 4 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

How does former Salter innominate osteotomy in patients with Legg–Calvé–Perthes disease influence acetabular orientation? An MRI-based study

Bellova

Goronzy

Blum

et al. 2021

Journal of Hip Preservation Surgery

View full text Add to dashboard Cite

Salter innominate osteotomy (SIO) has been successfully used in the treatment of Legg–Calvé–Perthes disease (LCPD). Recent studies that have raised concerns about acetabular retroversion after SIO have been based on plain radiographs. In order to assess the true acetabular orientation, the present study uses a specific magnetic resonance imaging (MRI) technique. In addition, the association between acetabular morphology and clinical function as well as health-related quality of life was assessed. Twenty-three patients with 24 operated hips who underwent SIO for LCPD between January 2004 and November 2014 were included. Mean age was 8.5 ± 2.2 years at surgery and 18.5 ± 2.9 years at follow-up. MRIs were conducted at 1.5 T using radial sequences. The analysis included the acetabular version, acetabular sector angles (ASAs) and alpha angles. Plain radiographs were used in order to obtain the Stulberg classification. Patient-related outcome measures included the international Hip Outcome Tool and Euroqol-5 dimensions scores. In comparison to the non-operated side, the MRI of previously operated hips showed no difference of version at the center of the femoral head but significantly decreased version just below the roof level. As a marker for posterior acetabular coverage, the ASAs between 9 and 11 o’clock were significantly decreased when compared with non-operated hips. In hips with a mild acetabular retroversion (<15°), the function was significantly decreased when compared with non-retroverted hips. The SIO is an effective tool in order to restore acetabular containment in LCPD. When compared with the non-operated hips, our collective displays only moderate changes of acetabular orientation and coverage.

show abstract

“…Similarly, 29 of 37 hips (78.4%) in a study by Ishida et al . were classified accordingly [ 10 ]. Similar results were found in other studies [ 4 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

How does former Salter innominate osteotomy in patients with Legg–Calvé–Perthes disease influence acetabular orientation? An MRI-based study

Bellova

Goronzy

Blum

et al. 2021

Journal of Hip Preservation Surgery

View full text Add to dashboard Cite

show abstract

“…Various researchers have confirmed the usefulness of dynamic arthrography in their papers, 5,37,42,43 although some have stated that information from dynamic arthrography did not change their surgical treatment protocol. 36,44,45 At our Institution, we use dynamic PAG during surgery because it allows us to assess the congruence of the joint and choose the best position of the FH in relation to the acetabulum.…”

Section: The Importance Of Dynamic Arthrographymentioning

confidence: 92%

Arthrogram in Legg-Calvé-Perthes Disease

Milani

Dobashi²

2011

Journal of Pediatric Orthopaedics

Self Cite

View full text Add to dashboard Cite

There is a consensus among researchers that the treatment for Legg-Calvé-Perthes disease, whether conservative or surgical, is always based on the concept of "containment," that is, maintaining the femoral head inside the acetabulum socket throughout the entire evolution of the disease. Thus, the size and shape of the proximal femoral epiphysis should be monitored during the evolution of the disease. Although diagnosis is carried out by conventional radiographies in many medical institutions, this examination does not give us this information. Therefore, it becomes necessary to resort to other examination techniques, such as pneumoarthrography and magnetic resonance imaging. In our institution, we noticed the importance of hip arthrography in Legg-Calvé-Perthes disease from a study carried out by Laredo in 1985 that classified the disease into 5 groups based on the form and size of the femoral head and its position in the labrum. According to this researcher, group III, which he called "hip at premature arthrographic risk," requires action and yields the best results. The researchers have the opinion that dynamic pneumoarthrography is the best method for establishing an ideal position for the femoral head in relation to the acetabulum when surgical treatment is indicated.

show abstract

“…In many centers in North America, innominate osteotomy is the preferred option for achieving containment 97 with some surgeons performing a Salter osteotomy ( Figure 11(d) ) and others performing a triple innominate osteotomy. 97 – 107 Compared with the femoral varus osteotomy, a triple pelvic osteotomy may have some advantages; no shortening of the limb, no increased inclination of the epiphyseal plate or the risk of a trendelenburg gait. Unlike the Salter osteotomy, a triple pelvic does not increase the pressure on the femoral head and offers better freedom of reorientation of the acetabulum with the axis of rotation at the joint and not at the pubic symphysis ( Figure 11(e) ).…”

Section: Managementmentioning

confidence: 99%

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg–Calvé–Perthes

Joseph,

Shah,

Perry

2023

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

Background: Legg–Calvé–Perthes disease is a self-limiting disorder that develops in children following interruption of the blood supply to the capital femoral epiphysis. This review outlines the current knowledge on the epidemiology, natural evolution, clinical spectrum, and management of the disease. Methods: The literature pertaining to these aspects of the disease were studied and summarized in this review. Results: Epidemiological studies suggest that environmental factors contribute to the causation of the disease. Incidence rates monitored over time indicate that the incidence of Legg–Calvé–Perthes disease is declining. The natural evolution followed on sequential plain radiographs enables division of the disease into Stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV. Reversible deformation of the capital occurs in Stages Ia–IIa simply on standing while irreversible deformation may occur in Stages IIb and IIIa. Treatment of Legg–Calvé–Perthes disease in Stages Ia–IIa aims to prevent the femoral head from getting deformed by containment and avoidance of weight-bearing. In Stages IIb and IIIa, treatment aims to remedy the effects of early irreversible deformation of the femoral head. In Stage IIIb and IV, treatment is directed to correcting the altered shape of the femoral head. The impression that these treatment methods are helpful is based on poor quality evidence. Conclusion: There is an urgent need to undertake Level I studies to establish the efficacy of currently treatment. Level of evidence: level V.

show abstract

Salter Innominate Osteotomy in the Treatment of Severe Legg-Calvé-Perthes Disease

Cited by 31 publications

References 42 publications

How does former Salter innominate osteotomy in patients with Legg–Calvé–Perthes disease influence acetabular orientation? An MRI-based study

How does former Salter innominate osteotomy in patients with Legg–Calvé–Perthes disease influence acetabular orientation? An MRI-based study

Arthrogram in Legg-Calvé-Perthes Disease

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg–Calvé–Perthes

Contact Info

Product

Resources

About