The favorable outcome of Bernese periacetabular osteotomy for the hip osteoarthritis in multiple epiphyseal dysplasia

Orphanet Journal of Rare Diseases

Research

Jia-Feng Chang¹  Sheng-Chieh Lin²  Yao-Yuan Chang³  Kuan-Wen Wu³  Ting-Ming Wang³  Chia-Che Lee³  Ken N. Kuo⁴ 

[1] Department of Internal Medicine, En Chu Kong Hospital, 237, New Taipei City, Taiwan;TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, 110, Taipei, Taiwan;Department of Orthopaedic Surgery, Chung Shan Medical University Hospital, 402, Taichung, Taiwan;Institute of Medicine, Chung Shan Medical University, 402, Taichung, Taiwan;Departments of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd., 100, Taipei City, Taiwan;Departments of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd., 100, Taipei City, Taiwan;Cochrane Taiwan, Taipei Medical University, 110, Taipei, Taiwan;

关键词: Multiple epiphyseal dysplasia;    Bernese periacetabular osteotomy;    Hip osteoarthritis and hip dysplasia;   

DOI  :  10.1186/s13023-023-02920-1

 received in 2022-08-31, accepted in 2023-09-20,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMultiple epiphyseal dysplasia (MED) is a rare congenital bone dysplasia. Patients with MED develop secondary hip osteoarthritis as early as the third to the fourth decade. Currently, there is no consensus on the prevention of the progressive hip osteoarthritis secondary to MED. The Bernese periacetabular osteotomy (PAO) is a joint-preserving surgery to reshape acetabulum and extend femoral head coverage. However, there is no documentary evidence for the effect of the procedure on MED hips.Patients and methodsWe analyzed the preliminary outcomes following the Bernese PAO in 6 MED hips. The average age at the time of surgery was 14.3 years (range from 11.4 to 17.2 years). For our study interest of time efficiency, radiographic parameters were analyzed preoperatively and 1 year postoperatively. The hip function was evaluated by the Harris Hip Score (HHS) before and after surgery.ResultsThe mean follow-up time was 1.7 years. The mean lateral center–edge angle increased from 3.8° to 47.1° (p = 0.02), anterior center–edge angle increased from 7.3° to 35.1° (p = 0.02), and acetabulum index decreased from 27.8° to 14.6° (p = 0.04). The femoral head coverage ratio increased from 66.8% to 100% (p = 0.02). The post-operative anteroposterior pelvic radiograph demonstrated all preoperative broken Shenton lines were reversed. The mean HHS improved from 67.3 to 86.7 (p = 0.05).ConclusionBernese PAO is a feasible treatment for hip disorders in MED patients. It reshapes acetabular and femoral morphology efficiently. In our study, the preliminary results showed the procedure not only improved radiographic outcomes but also hip function.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1

12951_2016_246_Article_IEq1.gif

Fig. 5

Fig. 18

12888_2023_5206_Article_IEq3.gif

Fig. 17

12888_2023_5206_Article_IEq1.gif

Fig. 1

Fig. 1

Fig. 12

Fig. 2

12936_2017_2045_Article_IEq18.gif

Fig. 3

Fig. 2

Fig. 1

Fig. 2

12951_2017_292_Article_IEq1.gif