ABSTRACT
BACKGROUND: Poliomyelitis results in a flaccid paralysis of muscles that can lead to hip instability. The objective of this study was to determine the results of the Bernese periacetabular osteotomy in patients with paralytic hips secondary to poliomyelitis. METHODS: Nine patients who had a Bernese periacetabular osteotomy were identified as having paralytic hip dysplasia secondary to poliomyelitis. All patients had hip pain and instability at the time of presentation. Clinical records and radiographs were reviewed. One patient did not return for physical examination at last follow-up. RESULTS: The mean length of follow-up was 103 months. All patients had a decrease in the severity of pain but less improvement in function, as hip abductor muscle strength was improved in only two of the eight patients examined. The average postoperative Harris hip score was 80.2. All patients had an improvement in the extrusion index, the acetabular index, and the lateral center-edge angle. According to the Tönnis radiographic classification, three patients progressed from Grade 0 to Grade 1 and one patient progressed from Grade 1 to 2. CONCLUSIONS: The correction obtained with use of the Bernese periacetabular osteotomy provides containment of the hip joint in patients with hip dysplasia secondary to poliomyelitis. The patients had a decrease in the severity of pain and less improvement in function. The results have been long-lasting and may have slowed the progression of osteoarthritis of the hip.
Subject(s)
Acetabulum/surgery , Hip Dislocation/surgery , Joint Instability/surgery , Osteotomy/methods , Poliomyelitis/complications , Acetabulum/diagnostic imaging , Acetabulum/physiopathology , Adolescent , Adult , Analysis of Variance , Arthralgia/etiology , Arthralgia/physiopathology , Child , Female , Follow-Up Studies , Hip Dislocation/diagnostic imaging , Hip Dislocation/etiology , Humans , Joint Instability/diagnostic imaging , Joint Instability/etiology , Male , Middle Aged , Pain Measurement , Poliomyelitis/diagnosis , Preoperative Care , Radiography , Range of Motion, Articular/physiology , Risk Assessment , Sampling Studies , Severity of Illness Index , Treatment Outcome , Young AdultABSTRACT
An 11-month-old neutered female crossbreed dog was admitted with left pelvic limb lameness. Radiographs and computed tomography identified an osteochondritis dissecans- (OCD) like lesion in the intercondylar fossa of the femur originating from the axial aspect of the medial femoral condyle. Stifle arthrotomy was performed in order to remove the bony fragment. It was concluded that the clinical features and location of this lesion indicate an osteochondritis dessicans-like lesion. Fragment removal was associated with an excellent outcome.
