Document Detail


Prevalence and treatment of intraarticular pathology recognized at the time of periacetabular osteotomy for the dysplastic hip.
MedLine Citation:
PMID:  23054510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The indication for hip arthrotomy accompanied by intraarticular work during periacetabular osteotomy (PAO) has not been precisely defined. To validate a role for routine hip arthrotomy accompanied by intraarticular work, frequent intraarticular pathology must exist, and the adjunct procedures must not be associated with inferior relief of pain, reduced function, radiographic osteoarthritis progression, or conversion to THA.
QUESTIONS/PURPOSES: (1) What is the prevalence of intraarticular pathology at the time of PAO? (2) Does concomitant hip arthrotomy with associated intraarticular work negatively affect PAO as reflected by differences in Harris hip scores (HHS), Tönnis grade, and failure rates?
METHODS: We retrospectively reviewed the intraarticular findings in all 151 patients who underwent PAO accompanied by routine hip arthrotomy and intraarticular work from 2002 to 2009. Using multivariate regression models, we compared the HHS and Tönnis grades of patients receiving arthrotomy with a cohort of 39 patients who received PAO alone.
RESULTS: The overall prevalence of intraarticular pathology identified during PAO was 89%. Eight (5.3%) failures were identified within the arthrotomy cohort with mean postoperative HHS, postoperative Tönnis grade, postoperative change in HHS, and postoperative change in Tönnis grade of 87.5, 0.7, 29.8, and 0.3, respectively. By contrast, seven (17.9%) failures were identified in the nonarthrotomy cohort. The mean postoperative HHS, postoperative Tönnis grade, postoperative change in HHS, and postoperative change in Tönnis grade for the nonarthrotomy cohort were 83.1, 1.3, 19.0, and 0.3, respectively.
CONCLUSIONS: We believe the high prevalence of intraarticular pathology is sufficient to warrant routine joint inspection at the time of PAO. Hip arthrotomy accompanied by intraarticular work at the time of PAO is safe and does not impose additional patient morbidity.
LEVEL OF EVIDENCE: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
John G Ginnetti; Christopher E Pelt; Jill A Erickson; Christin Van Dine; Christopher L Peters
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-21     Completed Date:  2013-05-28     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  498-503     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Arthroplasty, Replacement, Hip
Cartilage, Articular / pathology*,  surgery
Female
Hip Dislocation, Congenital / pathology*,  surgery
Hip Joint / pathology*,  surgery
Humans
Male
Osteoarthritis, Hip / epidemiology*,  pathology,  surgery
Osteotomy*
Prevalence
Prognosis
Retrospective Studies
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Slipped capital femoral epiphysis: prevalence, pathogenesis, and natural history.
Next Document:  Limb Lengthening and Reconstruction Society AIM index reliably assesses lower limb deformity.