TRIPLE PELVIC OSTEOTOMY IN THE TREATMENT OF HIP DYSPLASIA

Abstract

Introduction: Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and the triple pelvic osteotomy as the most recently introduced surgical treatment.

Objective: The study analyses pre- and postoperative pathoanatomical characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation.

Methods: The study involved 136 adolescents, treated with Salter and Chiari osteotomies or a triple pelvic osteotomy. The patients were between 10–20 years old at the time of operation. The following data from all the patients were analysed: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics.

Results: The average CE angle after triple pelvic osteotomy was 43.5 degrees, more improved than after the Salter osteotomy (33.0 degrees) and Chiari osteotomy (31.4 degrees). Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations. Preoperative painful discomfor was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of the effect of the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy) and increase in joint coverage (compared to Salter osteotomy).

Conclusion: Triple pelvic osteotomy is the method of choice in the management of acetabular dysplasia and other disturbances of hip joint containment in adolescent age.