The hip-shelf procedure. A long-term evaluation.

White, Rebecca; Sherman, Frederick C.

doi:10.2106/00004623-198062060-00007

Cited by 29 publications

(8 citation statements)

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“…Harris and Enneking (1995) have presented histological evidence to show that an appropriate osteotomy could provide durable regeneration of articular cartilage with remodelling of subchondral bone. Anatomical correction for a severely dysplastic hip with a false acetabulum is extremely difficult by any conventional operative procedure (Steel 1975;Sutherland and Greenfield 1977;Wagner 1978;Salter and Thompson 1979;White and Sherman 1980;Tönnis 1982;Reynolds 1986; Table II Case 1. Figure 6a -Preoperative radiograph showing a type-1 low false acetabulum with a CE angle of -18° in a 14-year-old girl.…”

Section: Discussionmentioning

confidence: 99%

Rotational Acetabular Osteotomy for Severe Dysplasia of the Hip With a False Acetabulum

Shindo

Igarashi

Taneda

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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We have divided Severin group-V severely dysplastic hips with a false acetabulum into three subtypes, based on the height and shape of the socket. We performed rotational acetabular osteotomy (RAO) in 19 hips in 17 young adults with a type-1 'low' false acetabulum which had direct contact with the true acetabulum. This is a periacetabular osteotomy which gives acetabular coverage with articular cartilage and produces a nearly normal position of the head. Concomitant osteotomies of the proximal femur were carried out in 11 hips. We reviewed the patients clinically and radiologically at a mean of ten years (6 to 18) after operation. Of the 19 hips, 15 showed very good or good results.This operation is indicated in young adults with a dysplastic hip and a type-1 low false acetabulum. Subclassification of Severin group V is a convenient way of defining those patients who would benefit from the procedure.

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Section: Discussionmentioning

confidence: 99%

Rotational Acetabular Osteotomy for Severe Dysplasia of the Hip With a False Acetabulum

Shindo

Igarashi

Taneda

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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“…However, an interposed articular capsule between the femoral head and ilium (in case of Chiari osteotomy) or bone graft (in shelf osteotomy) develops a cartilage metaplasia that could remember articular cartilage. 75,76…”

Section: Treatmentmentioning

confidence: 99%

Developmental dysplasia of the hip: update of management

et al. 2019

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The term ‘developmental dysplasia of the hip’ (DDH) includes a wide spectrum of hip alterations: neonatal instability; acetabular dysplasia; hip subluxation; and true dislocation of the hip. DDH alters hip biomechanics, overloading the articular cartilage and leading to early osteoarthritis. DDH is the main cause of total hip replacement in young people (about 21% to 29%). Development of the acetabular cavity is determined by the presence of a concentrically reduced femoral head. Hip subluxation or dislocation in a child will cause an inadequate development of the acetabulum during the remaining growth. Clinical screening (instability manoeuvres) should be done universally as a part of the physical examination of the newborn. After two or three months of life, limited hip abduction is the most important clinical sign. Selective ultrasound screening should be performed in any child with abnormal physical examination or in those with high-risk factors (breech presentation and positive family history). Universal ultrasound screening has not demonstrated its utility in diminishing the incidence of late dysplasia. Almost 90% of patients with mild hip instability at birth are resolved spontaneously within the first eight weeks and 96% of pathologic changes observed in echography are resolved spontaneously within the first six weeks of life. However, an Ortolani-positive hip requires immediate treatment. When the hip is dislocated or subluxated, a concentric and stable reduction without forceful abduction needs to be obtained by closed or open means. Pavlik harness is usually the first line of treatment under the age of six months. Hip arthrogram is useful for guiding the decision of performing a closed or open reduction when needed. Acetabular dysplasia improves in the majority due to the stimulus provoked by hip reduction. The best parameter to predict persistent acetabular dysplasia at maturity is the evolution of the acetabular index. Pelvic or femoral osteotomies should be performed when residual acetabular dysplasia is present or in older children when a spontaneous correction after hip reduction is not expected. Avascular necrosis is the most serious complication and is related to: an excessive abduction of the hip; a force closed reduction when obstacles for reduction are present; a maintained dislocated hip within the harness or spica cast; and a surgical open reduction.Cite this article: EFORT Open Rev 2019;4:548-556. DOI: 10.1302/2058-5241.4.180019

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“…Untreated acetabular dysplasia is the most common cause of secondary osteoarthritis of the hip and is caused by pathological joint-loading forces. 1,2 Options for operative treatment are osteotomy, total hip replacement (THR) and arthrodesis. Joint-preserving acetabular osteotomies include redirectional osteotomies (Salter and Bernese), reshaping osteotomies (Pemberton) and salvage augmentation procedures (shelf, Chiari).…”

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confidence: 99%

Is there a place for shelf acetabuloplasty in the management of adult acetabular dysplasia?

Fawzy

Mandellos

Steiger

et al. 2005

The Journal of Bone and Joint Surgery. British volume

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We followed up 76 consecutive hips with symptomatic acetabular dysplasia treated by acetabular shelf augmentation for a mean period of 11 years. Survival analysis using conversion to hip replacement as an end-point was 86% at five years and 46% at ten years. Forty-four hips with slight or no narrowing of the joint space pre-operatively had a survival of 97% at five and 75% at ten years. This was significantly higher (p = 0.0007) than that of the 32 hips with moderate or severe narrowing of the joint-space, which was 76% at five and 22% at ten years. There was no significant relationship between survival and age (p = 0.37) or the pre- and post-operative centre-edge (p = 0.39) and acetabular angles (p = 0.85). Shelf acetabuloplasty is a reliable, safe procedure offering medium-term symptomatic relief for adults with acetabular dysplasia. The best results were achieved in patients with mild and moderate dysplasia of the hip with little arthritis.

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The hip-shelf procedure. A long-term evaluation.

Cited by 29 publications

References 0 publications

Rotational Acetabular Osteotomy for Severe Dysplasia of the Hip With a False Acetabulum

Rotational Acetabular Osteotomy for Severe Dysplasia of the Hip With a False Acetabulum

Developmental dysplasia of the hip: update of management

Is there a place for shelf acetabuloplasty in the management of adult acetabular dysplasia?

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