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What Are the Factors Associated With Acetabular Correction in Perthes-like Hip Deformities?

  • Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Perthes-like hip deformities encompass variable proximal femoral abnormalities and associated acetabular dysplasia that can be reconstructed with contemporary hip preservation procedures. Nevertheless, the necessity and indications for surgical correction of associated acetabular dysplasia have not been established.

Questions/Purposes

We determined whether patient-specific factors (sex, age, BMI, previous surgery, hip pain and function) and/or structural deformity characteristics (radiographic parameters of acetabular morphology) were associated with our indications for acetabular reorientation in surgical reconstruction of Perthes-like hip deformities.

Methods

We compared patient-specific characteristics and radiographic parameters of acetabular morphology in 94 patients (97 hips) with residual Perthes deformities who underwent joint preservation surgery without or with a periacetabular osteotomy (PAO) as part of the reconstruction.

Results

Patient sex, BMI, preoperative Harris hip score, and previous hip surgery were not associated with our indications for a combined femoral and PAO procedure. Radiographic parameters associated with the indication for a PAO included the lateral center-edge angle, anterior center-edge angle, acetabular inclination, and acetabulum-head index. No or mild secondary osteoarthritis and joint congruency were associated with the indication for a PAO as part of the reconstruction.

Conclusions

Contemporary hip preservation surgery for residual Perthes deformities covers a wide spectrum of procedures. We believe a PAO should be considered in the surgical treatment plan for symptomatic patients having radiographic parameters indicating acetabular dysplasia, no or mild secondary osteoarthritis, and adequate joint congruity.

Level of Evidence

Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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Fig. 1A–B
Fig. 2A–B

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Acknowledgments

We thank Debbie Long for assistance with the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Hospital Plaza, Suite 11300 West Pavilion, Campus Box 8233, St Louis, MO, 63110, USA

    John C. Clohisy MD, James R. Ross MD, Joshua D. North MD, Jeffrey J. Nepple MD & Perry L. Schoenecker MD

Authors
  1. John C. Clohisy MD
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  2. James R. Ross MD
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  3. Joshua D. North MD
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  4. Jeffrey J. Nepple MD
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  5. Perry L. Schoenecker MD
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Corresponding author

Correspondence to John C. Clohisy MD.

Additional information

The institution of one or more of the authors (JJN) has received, during the study period, funding from Arthrex Hip Anatomical Study. The institution of one or more of the authors (JCC) has received, during the study period, research support from Zimmer, Inc (Warsaw, IN, USA) and the Curing Hip Disease Fund (St Louis, MO, USA). One of the authors (JCC) certifies that he, or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount less than $10,000, from Biomet Inc (Warsaw, IN, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Clohisy, J.C., Ross, J.R., North, J.D. et al. What Are the Factors Associated With Acetabular Correction in Perthes-like Hip Deformities?. Clin Orthop Relat Res 470, 3439–3445 (2012). https://doi.org/10.1007/s11999-012-2507-0

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  • DOI: https://doi.org/10.1007/s11999-012-2507-0

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