Factors influencing outcomes of pelvic osteotomy for residual acetabular dysplasia following closed reduction in patients with developmental dysplasia of the hip

作者全名：Li, YiQiang; Liu, Hang; Guo, YueMing; Chen, ShunYou; Canavese, Federico; Liu, YanHan; Li, JingChun; Xu, HongWen; Xia, HuiMin

作者地址：[Li, YiQiang; Xia, HuiMin] Jinan Univ, Affiliated Hosp 1, Guangzhou, Peoples R China; [Li, YiQiang; Canavese, Federico; Liu, YanHan; Li, JingChun; Xu, HongWen; Xia, HuiMin] Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Pediat Orthopaed, Guangzhou, Peoples R China; [Liu, Hang] Chongqing Med Univ, Dept Pediat Orthopaed, Childrens Hosp, Chongqing, Peoples R China; [Guo, YueMing] FoShan Hosp Tradit Chinese Med, Dept Pediat Orthopaed, Foshan, Peoples R China; [Chen, ShunYou] Xiamen Univ, Fuzhou Hosp 2, Dept Pediat Orthoped, Fuzhou, Peoples R China; [Canavese, Federico] Lille Univ Ctr, Jeanne de Flandre Hosp, Dept Pediat Orthoped, Lille, France

通信作者：Xia, HM (通讯作者)，Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Pediat Surg, Prov Key Lab Res Struct Birth Defect Dis, Guangzhou 510623, Peoples R China.

来源：JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001237229400005

JCR分区：Q3

影响因子：0.9

年份：2024

卷号：33

期号：4

开始页：340

结束页：347

文献类型：Article

关键词：closed reduction; DDH; outcome; pelvic osteotomy; residual acetabular dysplasia

摘要：To investigate the factors influencing outcome of pelvic osteotomy (PO) for residual acetabular dysplasia (RAD) following closed reduction (CR) in patients with developmental dysplasia of the hip (DDH). We retrospectively reviewed 91 patients (95 hips) with DDH who underwent PO for RAD. T & ouml;nnis grade, Acetabular index, Center Edge Angle, Reimer's Index (RI), and avascular necrosis of the femoral head (AVN) were assessed. Hips were divided into satisfactory (Severin I/II) and unsatisfactory group (Severin III/IV). Finally, 87 hips (91.5%) had satisfactory and 8 (8.5%) unsatisfactory outcomes. The RI before PO was significantly higher in unsatisfactory (49.6 +/- 9%) than in satisfactory group (30.6%+/- 11.8%). All patients without AVN had satisfactory outcome, while it was 78.9% of patients with AVN. Logistic regression analysis showed that higher AVN grade and RI before PO were risk factors for unsatisfactory outcome. Satisfactory outcome was obtained in all hips with RI < 33% before PO, while it was 79.5% if RI > 33% before PO (79.5%). There was no difference in the satisfactory rate between patients undergoing open reduction (66.7%) and those not undergoing (83.3%). The rate of satisfactory outcome in patients undergoing femoral osteotomy (63.6%) was lower than those without it (100%). In patients with RAD following CR, good outcome can be expected after PO alone. AVN and preoperative RI > 33% are risk factors for poor outcome. Additional open reduction and femoral osteotomy do not significantly improve outcome of PO in patients with preoperative RI > 33%.

基金机构：Guangzhou Women and Children's Medical Center/Guangzhou Institute of Pediatrics [GWCMC2020-6-005]

基金资助正文：This work was supported by funding from Guangzhou Women and Children's Medical Center/Guangzhou Institute of Pediatrics (Grant No. GWCMC2020-6-005).