Innominate Osteotomy in Adolescents and Adults Who Have Acetabular Dysplasia

• Published in: Journal of bone and joint surgery. American volume 1996-10, Vol.78 (10), p.1455-61
• Main Authors: MCCARTHY, JAMES J, FOX, JOHN S, GURD, ALAN R
• Format: Article
• Language: English
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - pathology; Adolescent; Adult; Biological and medical sciences; Child; Female; Follow-Up Studies; Hip Dislocation, Congenital - diagnostic imaging; Hip Dislocation, Congenital - pathology; Hip Dislocation, Congenital - surgery; Hip Joint - diagnostic imaging; Hip Joint - pathology; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteotomy - methods; Patient Satisfaction; Pelvic Bones - surgery; Postoperative Complications; Radiography; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-199610000-00001

The results were evaluated for twenty-eight adolescents and adults (thirty-one hips) who had had a Salter innominate osteotomy because of acetabular dysplasia and pain in the hip. The mean age at the time of the index operation was twenty-two years, and the mean duration of radiographic follow-up was seventy-one months. Radiographs were available for twenty-five patients (twenty-eight hips) at the most recent follow-up evaluation. The radiographic evaluation included determination of the acetabular angle, the center-edge angle, the coverage of the femoral head, the height of the joint space, and the Shenton line. Compared with the preoperative measurements, the acetabular angle had decreased by a mean of 10.0 degrees, the center-edge angle had increased by a mean of 13.2 degrees, and the coverage of the femoral head had increased by a mean of 15 per cent (p < 0.001 for all three values). The height of the joint space had decreased but, with the numbers available, this change was not significant. The Harris hip scores, determined for twenty patients (twenty-one hips), improved from a mean of 71.2 points preoperatively to a mean of 88.3 points at the latest follow-up evaluation (p < 0.001). A questionnaire, completed by twenty-seven patients (thirty hips), revealed that twenty-one patients (78 per cent) were satisfied with the result of the operation; twenty-two patients (81 per cent) said that they would recommend this procedure to others who had a similar condition. The pain score (with 1 point indicating mild pain and 5 points indicating severe pain) improved from a mean of 3.7 points preoperatively to a mean of 2.5 points at the latest follow-up evaluation (p < 0.001). There were six postoperative complications. One patient had a non-union; one, an infection; one, heterotopic bone; and three, numbness. Two of these patients subsequently had a total hip arthroplasty at ninety-eight and 150 months, and one patient had a Chiari osteotomy at twenty-two months. Our findings demonstrate that the Salter innominate osteotomy provides notable clinical improvement as well as improvements in the radiographic measurements of the hip in patients who have acetabular dysplasia.