Triple Pelvic Osteotomy for Hip Dysplasia: The Akbulut-Coskun Technique Using a Modified Stoppa Approach.

IF 1.4 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2025-03-01 Epub Date: 2024-11-08 DOI:10.1097/BPO.0000000000002851
Deniz Akbulut, Mehmet Coşkun, Abdurrahman Aydin, Fatih Arslanoğlu, Ahmet Sevencan, Yalkin Çamurcu
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引用次数: 0

Abstract

Background: Many successful osteotomies have been reported for the treatment of acetabular dysplasia. However, triple pelvic osteotomy remains a technically challenging procedure with potential for significant complications. This study examined a series of Tönnis periacetabular osteotomy (TPAO) procedures performed using the modified Stoppa approach to treat acetabular dysplasia in adolescents.

Objective: To describe the radiographic outcomes, complications, and early functional results of TPAO using the modified Stoppa approach for acetabular dysplasia in adolescents.

Methods: This study included 16 patients (20 hips) who underwent TPAO using the modified Stoppa approach for symptomatic acetabular dysplasia. The characteristics of the patients and the surgical procedure were discussed. The radiologic outcome was evaluated using the lateral center-edge (CE) and Tönnis roof angles. Perioperative data including surgery duration, blood loss, and complications were recorded. Complications were also discussed.

Results: The mean age of the patients was 11.5±1.1 (10 to 13) years. The mean preoperative anteroposterior CE angle was 14.7±3 degrees (7 to 19 degrees), and the mean postoperative angle was 35.7±3.1 degrees (30 to 42 degrees; P <0.001). The mean preoperative Sharp's angle was 55.9±5.4 degrees (48 to 65 degrees), and the postoperative mean was 33±5 degrees (24 to 40 degrees; P <0.001). The mean Tönnis angle before and after osteotomy was 23.3±7.1 degrees (17 to 36 degrees) and 7.1±2 degrees (4 to 10 degrees), respectively ( P <0.001). The mean operative time was 42.2±10.3 minutes with a mean blood loss of 167.7±50.3 mL. One patient sustained a bladder injury as a major complication.

Conclusions: The use of TPAO with the intrapelvic modified Stoppa approach in the treatment of hip dysplasia provides the benefits of a single incision, access to 2 hips in the same session, positional advantage, and abductor function preservation. Early results are satisfactory and safe.

Level of evidence: Level IV.

治疗髋关节发育不良的三骨盆截骨术:使用改良 Stoppa 方法的 Akbulut-Coskun 技术。
背景:已有许多成功截骨治疗髋臼发育不良的报道。然而,三骨盆截骨术在技术上仍是一项具有挑战性的手术,有可能出现严重的并发症。本研究对一系列使用改良Stoppa方法治疗青少年髋臼发育不良的Tönnis髋臼周围截骨术(TPAO)进行了研究:描述使用改良Stoppa方法进行TPAO治疗青少年髋臼发育不良的放射学结果、并发症和早期功能效果:本研究纳入了16例(20个髋关节)因症状性髋臼发育不良而采用改良Stoppa方法进行TPAO手术的患者。研究讨论了患者的特征和手术方法。使用外侧中心边缘角(CE)和Tönnis顶角对放射学结果进行了评估。记录了围手术期的数据,包括手术时间、失血量和并发症。还对并发症进行了讨论:患者的平均年龄为 11.5±1.1(10 至 13)岁。术前CE前后角的平均值为14.7±3度(7至19度),术后CE前后角的平均值为35.7±3.1度(30至42度):在髋关节发育不良的治疗中使用TPAO和骨盆内改良Stoppa入路具有单切口、在同一次手术中可治疗2个髋关节、位置优势和外展功能保留等优点。早期效果令人满意且安全:证据等级:IV 级。
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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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