Short to Midterm Results of Bernese Periacetabular Osteotomy for Hip Dysplasia / 대한정형외과학회잡지

PURPOSE: The goal of this study was to analyze the short to midterm results of Bernese periacetabular osteotomy for the patient with hip dysplasia. MATERIALS AND METHODS: Fourteen Bernese periacetabular osteotomies were performed in 13 patients and were followed-up for more than 2.5 years. All patients had been treated at Department of Orthopedic Surgery, Seoul National University Hospital from June 1998 to December 2007. We conducted an interview and asked the patients to complete the Harris hip score and pain visual analogue scale (VAS) score for clinical evaluation. Radiographic measurements included Tonnis osteoarthritis grade, center-edge angle of Wiberg, acetabular angle of Sharp, acetabular depth index, acetabular head index. RESULTS: Mean Harris hip score improved from 63.8 points preoperatively to 82.9 points postoperatively and pain VAS score improved from 7.6 points preoperatively to 0.8 points postoperatively. Based on Tonnis osteoarthritis grade, progression of osteoarthritis was found in 4 hips. Radiologically, center-edge angle of Wiberg, acetabular angle of Sharp, acetabular depth index and acetabular head index improved. Complications included superficial skin infection in one hip and non-union of pubic ramus in one. One patient had metal hypersensitivity to cortical screws and fracture of posterior column. CONCLUSION: The short to midterm results show Bernese periacetabular osteotomy is a satisfactory technique for treating early and mild hip-osteoarthritis patients with hip dysplasia clinically and radiographically.

Bernese Periacetabular Osteotomy for Treatment of Acetabular Dysplasia / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiologic results of Bernese periacetabular osteotomy in treating acetabular dysplasia. MATERIALS AND METHODS: We evaluated the results of 24 Bernese periacetabular osteotomies performed in 21 patients (18 female, 3 male). The osteotomies were performed through an ilioinguinal approach in 20 cases, and dual (anterior and posterior) approaches in 4 cases. The mean age of the patients at the time of surgery was 23.4 years (range, 13.1-36 years). The average follow-up period was 26 months (range, 12-48 months). The Harris hip score was used for clinical evaluation. Radiological changes of acetabular angle, CE angle, acetabular depth, and femoral head coverage were measured. RESULTS: Clinically, the mean Harris hip score improved from 59.3 preoperatively to 88.3 postoperatively. All four radiological measurements improved significantly after surgery (Wilcoxon Rank Sum test, p<0.05). The following complications were noted: superficial skin infection (1 case), posterior column fracture (3 cases), temporary sciatic nerve symptoms (2 cases), and conversion to total hip arthroplasty (2 cases). CONCLUSION: Bernese periacetabular osteotomy is an effective surgical treatment for acetabular dysplasia in adults.

Bernese Periacetabular Osteotomy Using Dual Approaches for Hip Dysplasias / 대한정형외과학회잡지

PURPOSE: This study was aimed to evaluate the usefulness of the dual approaches used in Bernese periacetabular osteotomy for hip dysplasias, and also to comparatively evaluate the single anterior approach. MATERIALS AND METHODS: We performed a clinical and radiographic assessment of 15 cases (5 cases by the anterior approach and 10 cases by the dual approaches) of periacetabular osteotomy which had been followed up for more than 1 year. RESULTS: All patients had an improved Harris hip score, CE angle, acetabular angle, acetabular depth, femoral head coverage and medial shift of the femoral head. Gait improvement was confirmed by gait analysis. The mount of correction of the CE angle was more by the anterior approach than by the dual approaches, which was due to overcorrection. There were no statistical differences in the operation times or in the amounts of bleeding of the two approaches. Posterior column fractures occurred in 4 hips, which were due to blind osteotomies by the single approach, but none occurred after the dual approaches. CONCLUSION: We visualized all osteotomy sites and could perform the osteotomies easily and were able to decrease the number of complications associated with the dual approaches.