International Orthopaedics

, Volume 42, Issue 5, pp 1029–1034 | Cite as

Incidence of delayed union one year after peri-acetabular osteotomy based on computed tomography

  • Shunsuke Akiho
  • Koichi Kinoshita
  • Ayumi Matsunaga
  • Satohiro Ishii
  • Hajime Seo
  • Jun Nishio
  • Takuaki Yamamoto
Original Paper
  • 94 Downloads

Abstract

Background

Pubic bone nonunion and delayed union are reported as post-operative complications after peri-acetabular osteotomy (PAO). However, few studies have determined the incidence of delayed union using computed tomography (CT) scans. This study aimed to determine the incidence of delayed union at one year after PAO using X-ray and CT scans.

Methods

We performed a retrospective review of 150 hips in 132 consecutive patients with acetabular dysplasia who underwent PAO between January 2012 and June 2016 and evaluated 107 hips for which pelvic CT scans taken at one year after PAO were available. Clinical evaluations included age at surgery, weight, body mass index (BMI) and history. Radiographic evaluations were to assess pubic, ischial and iliac delayed union at one year post-operatively.

Results

Based on X-ray analysis, the incidence of delayed union in the pubic, ischial and iliac bones was 11.2% (12 hips), 5.6% (6 hips) and 0% (0 hips), respectively, and20.6% (22 hips), 8.4% (9 hips) and 0% (0 hips), respectively, based on CT scans.

Conclusion

The incidence of delayed union of the pubis and ischium at one year after PAO according to CT scans was higher than that based on X-ray imaging. CT scans are useful in patients with some symptoms at the osteotomy site.

Level of Evidence: Level III.

Keywords

Peri-acetabular osteotomy Nonunion Delayed union Computed tomography scans 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Ganz R, Klaue K, Vinh T, Mast JW (1988) A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res 232:26–36Google Scholar
  2. 2.
    Gala L, Clohisy JC, Beaule PE (2016) Hip dysplasia in the young adult. J Bone Joint Surg Am 98:63–73CrossRefPubMedGoogle Scholar
  3. 3.
    Murphy SB, Millis MB, Hall JE (1999) Surgical correction of acetabular dysplasia in the adult. A Boston experience. Clin Orthop Relat Res 363:38–44CrossRefGoogle Scholar
  4. 4.
    Naito M, Shiramizu K, Akiyoshi Y, Ezoe M, Nakamura Y (2005) Curved periacetabular osteotomy for treatment of dysplastic hip. Clin Orthop Relat Res 433:129–135CrossRefGoogle Scholar
  5. 5.
    Braatz F, Staude D, Klotz MC, Wolf SI, Dreher T, Lakemeier S (2016) (2016) Hip-joint congruity after Dega osteotomy in patients with cerebral palsy: long-term results. Int Orthop 40(8):1663–1668.  https://doi.org/10.1007/s00264-015-3013-2 CrossRefPubMedGoogle Scholar
  6. 6.
    Steppacher SD, Tannast M, Ganz R, Siebenrock KA (2008) Mean 20-year followup of bernese periacetabular osteotomy. Clin Orthop Relat Res 466(7):1633–1644CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Matheney T, Kim YJ, Zurakowski D, Matero C (2009) Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome. J Bone Joint Surg Am 91(9):2113–2123CrossRefPubMedGoogle Scholar
  8. 8.
    Thawrani D, Sucato DJ, Podeszwa DA, DeLaRocha A (2010) Complications associated with the Bernese periacetabular osteotomy for hip dysplasia in adolescents. J Bone Joint Surg Am 92(8):1707–1714CrossRefPubMedGoogle Scholar
  9. 9.
    Diana R, Mirjana M, Oliver U, Johannes E (2016) The anatomical course of the lateral femoral cutaneous nerve with special attention to the anterior approach to the hip joint. J Bone Joint Surg Am 98:561–567CrossRefGoogle Scholar
  10. 10.
    Novais EN, Heare T, Kestel L, Oliver P, Boucharel W, Koerner J, Strupp K (2017) (2017) Multimodal nerve monitoring during periacetabular osteotomy identifies surgical steps associated with risk of injury. Int Orthop 41(8):1543–1551.  https://doi.org/10.1007/s00264-016-3394-x CrossRefPubMedGoogle Scholar
  11. 11.
    Matta JM, Stover MD, Siebenrock K (1999) Periacetabular osteotomy through the Smith-Petersen approach. Clin Orthop Relat Res 363:21–32Google Scholar
  12. 12.
    Peters CL, Erickson JA (2006) Treatment of femoro-acetabular impingement with surgical dislocation and debride-ment in young adult. J Bone Joint Surg Am 88:1735–1741CrossRefPubMedGoogle Scholar
  13. 13.
    Malviya A, Dandachli W, Beech Z, Bankes MJ (2015) The incidence of stress fracture following peri-acetabular osteotomy. Bone Joint J 97-B:24–28CrossRefPubMedGoogle Scholar
  14. 14.
    Tsuboi M, Fujita K, Kawabe K, Hasegawa Y (2011) Pubic/ischial stress fractures after eccentric rotational acetabular osteotomy. J Orthop Sci 16(1):38–43CrossRefPubMedGoogle Scholar
  15. 15.
    Peters CL, Erickson JA, Hines JL (2006) Early Results of the Bernese Periacetabular Osteotomy: The Learning Curve at an Academic Medical Center. J Bone Joint Surg Am 88(9):1920–1926PubMedGoogle Scholar
  16. 16.
    Clohisy JC, Barrett SE, Gordon JE, Delgado ED (2005) Periacetabular osteotomy for the treatment of severe acetabular dysplasia. J Bone Joint Surg Am 87(2):254–259CrossRefPubMedGoogle Scholar
  17. 17.
    Clohisy JC, Schutz AL, John LS, Schoenecker PL (2009) Periacetabular osteotomy. Clin Orthop Relat Res 467:2041–2052CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Xuyi W, Jianping P, Junfeng Z, Chao S, Yimin C, Xiaodong C (2016) (2016) Application of three-dimensional computerised tomography reconstruction and image processing technology in individual operation design of developmental dysplasia of the hip patients. Int Orthop 40(2):255–265.  https://doi.org/10.1007/s00264-015-2994-1 CrossRefPubMedGoogle Scholar
  19. 19.
    Murphy S, Deshmukh R (2002) Periacetabular osteotomy: preoperative radiographic predictors of outcome. Clin Orthop Relat Res 405:168–174CrossRefGoogle Scholar
  20. 20.
    Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755CrossRefPubMedGoogle Scholar
  21. 21.
    Yasunaga Y, Ikuta Y, Kanazawa T, Hisatome T (2001) The state of the articular cartilage at the time of surgery as an indication for rotational acetabular osteotomy. J Bone Joint Surg (Br) 83(B):1001–1004Google Scholar
  22. 22.
    Tönnis D, Heinecke A (1999) Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 81(12):1747–1770CrossRefPubMedGoogle Scholar
  23. 23.
    Trumble SJ, Mayo KA, Mast JW (1999) The Periacetabular Osteotomy: Minimum 2 Year Followup in More Than 100 Hips. Clin Orthop Relat Res 363:54–63CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2017

Authors and Affiliations

  • Shunsuke Akiho
    • 1
  • Koichi Kinoshita
    • 1
  • Ayumi Matsunaga
    • 1
  • Satohiro Ishii
    • 1
  • Hajime Seo
    • 1
  • Jun Nishio
    • 1
  • Takuaki Yamamoto
    • 1
  1. 1.Department of Orthopaedic SurgeryFukuoka University Faculty of MedicineFukuokaJapan

Personalised recommendations