Can Chiari Osteotomy Favorably Influence Long-term Hip Degradation in Multiple Epiphyseal Dysplasia and Pseudoachondroplasia?
| Autor: | Zagorka Pejin, Christophe Glorion, Alina Badina, Georges Finidori, Aurélie Andrzejewski, Philippe Wicart |
|---|---|
| Přispěvatelé: | Medicine and Pharmacy academic/administration, Orthopaedics - Traumatology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Adolescent Arthroplasty Replacement Hip Radiography Kaplan-Meier Estimate Osteoarthritis Osteochondrodysplasias Short stature Achondroplasia Multiple epiphyseal dysplasia Young Adult 03 medical and health sciences Pseudoachondroplasia Femoral head 0302 clinical medicine medicine Hip Dislocation Humans Orthopedics and Sports Medicine Survival rate Retrospective Studies 030222 orthopedics business.industry Acetabulum Femur Head General Medicine Middle Aged medicine.disease Biomechanical Phenomena Osteotomy Surgery Treatment Outcome medicine.anatomical_structure Chiari osteotomy Pediatrics Perinatology and Child Health Female Hip Joint medicine.symptom business |
| Popis: | BACKGROUND: Multiple epiphyseal dysplasia (MED) and pseudoachondroplasia (PSACH) are congenital skeletal disorders characterized by irregular epiphyses, mild or severe short stature and early-onset osteoarthritis which frequently affect the hips. The current study evaluates the long-term results of the Chiari osteotomy in MED and PSACH patients. METHODS: Twenty patients (14 MED and 6 PSACH) were retrospectively included. Clinical assessment used the Postel Merle d'Aubigné (PMA) score and the Hip disability and Osteoarthritis Outcome Score (HOOS). Risser index, Sharp angle, acetabular depth index, center-edge angle, Tönnis angle, and femoral head coverage were measured on the preoperative radiographs and at last follow-up. The Treble index, which identifies the hip at risk in MED patients, was also determined. Stulberg classification (grades I to V) was used to evaluate the risk of osteoarthritis in the mature hips.Statistical analyses determined differences between preoperative and postoperative data. The Kaplan Meier method was used to calculate the survival rate of the operated hips using total hip arthroplasty as the endpoint. RESULTS: Thirty-three hips which underwent a Chiari osteotomy were reviewed. The average follow-up was 20.1 years. The PMA scores were significantly better at last follow-up than preoperatively. All radiographic parameters significantly improved. Moreover, the Sharp angle, center-edge angle, and femoral head coverage improved to a normal value at hip maturity. All of the operated hips had a Treble index of type I. At hip maturity, a majority of hip were aspherical congruent (Stulberg grades of III and IV). The survival rate of the operated hips was 80.7% at 24 years postoperative. CONCLUSIONS: The Chiari osteotomy is a satisfying solution for severe symptomatic hip lesions in MED and PSACH patients. At long-term follow-up, this procedure lessens pain and improves hip function, which delays total hip arthroplasty indication. LEVEL OF EVIDENCE: Level IV. |
| Databáze: | OpenAIRE |
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