Abstract
Introduction: Chiari osteotomy with capsuloplasty is an acetabulum-widening osteotomy which makes it possible to substantially correct dysplastic hips. This paper presents an overview of the results obtained after 25 years.
Materials and methods: Between 1983 and 2002, 127 Chiari osteotomies were carried out. 103 were revised (59 women, 40 men , 4 bilateral). Mean follow up: 11.2 years (range: 1 to 20 years). The endpoints were: operative time, VCA angles, acetabular inclination, pre-post-follow up CE angle, Merle d’Aubigne score, preop and postop Ahlbach score.
Results: Operative time: 1h 42′ (range: 57′ – 3h 10′). Ahlbach I – 26, II – 59, III – 18, IV – 0. Associated operations: Femoral osteotomy 77, varus-derotation osteotomy 36, Reconversion 31, Trochanteric retensioning. M 69. Angles measurement: preop: CE 5° (−34°−25°), VCA 18° (7°–26°), Tönnis 56° (43°–61°). Postop: CE 34° (10°–55°), VCA 31° (26°–39°), Tönnis 40° (38°–44°). Mean increase in acetabular inclination:16°. Merle d’Aubigné: preop 14.3(7–17), Follow-up 16.2(12–18). Excellent-good results 89(86.4%), Fair-poor results 14(14.6%) 2 went on to THA; Mean osteotomy displacement 26 mms (18–39). Invariability Ahlbach changes: If preop I 24/26(92.3%), if preop II 42/59(71.2%), if preop III 5 /18 (27.7%). Survival rate: 81.76% after 10 years.
Discussion and conclusions: Long term results seem satisfactory, with a survival rate of 81.76% after 10 years. This is a technique of choice in dysplasias with a new cup and in non-congruent hips, generally associated to a femoral osteotomy (77/103). It is crucial to perform the preop planning using Pawels test.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be sent to him at Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos, 108, 28015-Madrid, Spain
