Can salter osteotomy correct late diagnosed hip dysplasia: A retrospective evaluation of 49 hips after 6.7 years? - 02/07/18

Doi : 10.1016/j.otsr.2018.05.004

Florian Schmidutz ^a,^b,^⁎ , Johannes Roesner ^a, Thomas R. Niethammer ^a, Alexander C. Paulus ^a, Bernhard Heimkes ^a, Patrick Weber ^a
^a University of Munich (LMU), Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Germany
^b University of Tübingen, BG Trauma Center Tübingen, Germany

^⁎Corresponding author at: University of Tübingen, BG Trauma Center, 95, Schnarrenbergstrasse, 72076 Tübingen, Germany.University of Tübingen, BG Trauma Center95, SchnarrenbergstrasseTübingen72076Germany

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Abstract

Background

Surgical treatment of late diagnosed development dysplasia of the hip (DDH) remains challenging with several methods being described. We therefore retrospectively evaluated the outcome of salter innominate osteotomy (SIO) in patients with fully-grown bone, to evaluate whether this surgical procedure allows sufficient acetabular correction.

Material and methods

Between 2004–2012 SIO had been performed in 45 patients (49 hips) with late diagnosed DDH. The evaluation included pre- and postoperative radiographs (n=49), the complication rate (n=49) and the clinical outcome (WOMAC, HHS, UCLA) (n=34).

Results

Mean age at surgery was 27.6 (16–51) with a follow-up of 6.7±2.7 (0.9–11.0) years. Radiologically, a good acetabular correction with a significant improvement of the Center Edge angle (15.4° to 34.9°), sharps angle (45.7° to 32.0°) and migration percentage (33.2% to 14.4%) (p<0.001) was found. Clinical results revealed a WOMAC of 13.9±13.3, UCLA of 7.8±2.1 and HHS of 85.0±11.8. Complications were noted for 10 patients (20%) with 7 (14%) requiring revision.

Conclusion

The results demonstrated that SIO achieved a satisfying acetabular correction and good clinical results in late diagnosed DDH. It therefore might be an option in some cases, although periacetabular osteotomy techniques are currently preferable used as they allow a wider range of acetabular correction.