Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease

Objective: Disparity in size between femoral head and acetabulum could promote premature degeneration of the hip joint. The purpose of this study was to report the results of Kawamura's dome osteotomy for acetabular dysplasia due to sequelae of Perthes' disease. Patients and Methods: Fourt...

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Main Authors: Asep Santoso, Pramod Shaligram Ingale, Ik-Sun Choi, Young-Rok Shin, Kyung-Soon Park, Taek-Rim Yoon
Format: Article
Language:English
Published: AVES 2018-05-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X17304443
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author Asep Santoso
Pramod Shaligram Ingale
Ik-Sun Choi
Young-Rok Shin
Kyung-Soon Park
Taek-Rim Yoon
author_facet Asep Santoso
Pramod Shaligram Ingale
Ik-Sun Choi
Young-Rok Shin
Kyung-Soon Park
Taek-Rim Yoon
author_sort Asep Santoso
collection DOAJ
description Objective: Disparity in size between femoral head and acetabulum could promote premature degeneration of the hip joint. The purpose of this study was to report the results of Kawamura's dome osteotomy for acetabular dysplasia due to sequelae of Perthes' disease. Patients and Methods: Fourteen patients (14 hips) operated between 1999 and 2012 were retrospectively reviewed. There were 9 males and 5 females with a mean age of 29 years (range, 15–54 years). Functional and radiological results were reviewed at mean follow-up of 9 years (range, 4–12 years). Results: Pain relief was obtained in 13 of 14 (92.8%) patients postoperatively. Good to excellent functional outcome was obtained in 10 of 14 (71.4%) patients. Mean Harris hip score was improved from 63 to 84 (p < 0.05) at the final follow-up. Improvement of limping gait was observed in 10 of 14 (71.4%) patients. Center edge angle improved from mean 24° (11–36°) preoperatively to mean 35° (27–46°) postoperatively (p < 0.05), acetabular angle improved from mean 43° (36–49°) preoperatively to mean 37° (32–44°) postoperatively (p < 0.05), acetabular head index improved from mean 69% (50–83%) preoperatively to mean 85% (73–100%) postoperatively (p < 0.05). Progression of arthrosis stage occurred in 3 of 14 (21%) patients. None of the hip with preoperative Stulberg III, 2 of 9 hips with Stulberg IV and 2 of 2 hips with Stulberg V needed conversion to total hip arthroplasty during the follow-up. Conclusion: Dome osteotomy of the pelvis combined with trochanteric advancement could give a reasonable treatment outcome for acetabular dysplasia due to Perthes' disease at mid to long-term follow-up. Advanced stage of arthrosis, preoperative Stulberg V and no improvement of limping gait after the surgery possibly associated with poor outcome. Level of evidence: Level IV, therapeutic study. Keywords: Dome osteotomy, Trochanteric advancement, Acetabular dysplasia, Perthes' disease, Sequelae
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spelling doaj-art-ddafb10488824ef1bffd679d23fc332a2025-08-20T03:57:52ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2018-05-0152321622110.1016/j.aott.2018.02.010Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' diseaseAsep Santoso0Pramod Shaligram Ingale1Ik-Sun Choi2Young-Rok Shin3Kyung-Soon Park4Taek-Rim Yoon5Department of Orthopaedic and Traumatology, Prof. Dr. R. Soeharso Orthopaedic Hospital, Sebelas Maret University, Solo, IndonesiaCenter for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Republic of KoreaCenter for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Republic of KoreaCenter for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Republic of KoreaCenter for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea; Corresponding author. Department of Orthopedic Surgery, Center for Joint Disease at Chonnam National University Hwasun Hospital, 322, SeoYang-Ro, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, Republic of Korea. Tel.: +82 61 379 7677, 7676. Fax: +82 61 379 7681.Center for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Republic of KoreaObjective: Disparity in size between femoral head and acetabulum could promote premature degeneration of the hip joint. The purpose of this study was to report the results of Kawamura's dome osteotomy for acetabular dysplasia due to sequelae of Perthes' disease. Patients and Methods: Fourteen patients (14 hips) operated between 1999 and 2012 were retrospectively reviewed. There were 9 males and 5 females with a mean age of 29 years (range, 15–54 years). Functional and radiological results were reviewed at mean follow-up of 9 years (range, 4–12 years). Results: Pain relief was obtained in 13 of 14 (92.8%) patients postoperatively. Good to excellent functional outcome was obtained in 10 of 14 (71.4%) patients. Mean Harris hip score was improved from 63 to 84 (p < 0.05) at the final follow-up. Improvement of limping gait was observed in 10 of 14 (71.4%) patients. Center edge angle improved from mean 24° (11–36°) preoperatively to mean 35° (27–46°) postoperatively (p < 0.05), acetabular angle improved from mean 43° (36–49°) preoperatively to mean 37° (32–44°) postoperatively (p < 0.05), acetabular head index improved from mean 69% (50–83%) preoperatively to mean 85% (73–100%) postoperatively (p < 0.05). Progression of arthrosis stage occurred in 3 of 14 (21%) patients. None of the hip with preoperative Stulberg III, 2 of 9 hips with Stulberg IV and 2 of 2 hips with Stulberg V needed conversion to total hip arthroplasty during the follow-up. Conclusion: Dome osteotomy of the pelvis combined with trochanteric advancement could give a reasonable treatment outcome for acetabular dysplasia due to Perthes' disease at mid to long-term follow-up. Advanced stage of arthrosis, preoperative Stulberg V and no improvement of limping gait after the surgery possibly associated with poor outcome. Level of evidence: Level IV, therapeutic study. Keywords: Dome osteotomy, Trochanteric advancement, Acetabular dysplasia, Perthes' disease, Sequelaehttp://www.sciencedirect.com/science/article/pii/S1017995X17304443
spellingShingle Asep Santoso
Pramod Shaligram Ingale
Ik-Sun Choi
Young-Rok Shin
Kyung-Soon Park
Taek-Rim Yoon
Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease
Acta Orthopaedica et Traumatologica Turcica
title Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease
title_full Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease
title_fullStr Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease
title_full_unstemmed Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease
title_short Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease
title_sort treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of perthes disease
url http://www.sciencedirect.com/science/article/pii/S1017995X17304443
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