Ultra-long-term results of the Chiari pelvic osteotomy in hip dysplasia patients: a minimum of thirty-five years follow-up.

Autor: Chiari C; Division of Orthopaedics, Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. catharina.chiari@meduniwien.ac.at., Schneider E; Division of Orthopaedics, Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria., Stamm T; Center for Medical Statistics, Informatics and Intelligent Systems, Institute of Outcomes Research, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Peloschek P; Radiology Center, Lazarettgasse 25, 1090, Vienna, Austria., Kotz R; Vienna Private Hospital, Pelikangasse 15, 1090, Vienna, Austria., Windhager R; Division of Orthopaedics, Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2024 Jan; Vol. 48 (1), pp. 291-299. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1007/s00264-023-05912-9
Abstrakt: Purpose: The Chiari pelvic osteotomy was the first surgical procedure to address hip dysplasia by changing the position of the acetabulum by medialization, thus creating a bony roof and improving biomechanical conditions. The aim of this retrospective cohort study was to report on the very long-term results of this technique.
Methods: Out of a consecutive series of 1536 hips, 504 in 405 patients were available for follow-up. The patients were assessed by physical and radiological examination. A Kaplan-Meier survival analysis with total hip arthroplasty as an endpoint was performed and stratified for age groups, pre-operative diagnosis, sex and osteoarthritis stage.
Results: The average follow-up was 36 ± 8.1 years (range, 35.2 to 54). The average pain level on the Visual Analogue Scale was 2.9 ± 2.6 (range 0 to 8.7). The average Harris Hip Score was 80.2 ± 17.4 (range 17.4 to 100). Correction of dysplasia was effective and remained stable over time. Osteoarthritis significantly increased over time with 53% Tönnis grade 3 at follow-up. The cumulative survivorship was 79.8% (95% confidence interval (CI), 76.1-83.2%) at 20 years, 57.1% (95% CI, 52.8-61.8%) at 30 years and 35% (95% CI, 30.3-40.3%) at 40 years. Young age, male sex and low osteoarthritis grade were positive prognostic factors.
Conclusions: Although the Chiari pelvic osteotomy is considered a salvage procedure nowadays, it achieved excellent long-term results even in indications, which would be treated differently today. Young patients without osteoarthritis had the best outcome.
(© 2023. The Author(s).)
Databáze: MEDLINE
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