HIP International最新文献

{"title":"Spherical periacetabular osteotomy via para-sartorial intermuscular approach with bikini incision for patients with acetabular dysplasia: surgical technique and preliminary results.","authors":"Toru Nishiwaki, Toshihiko Hara, Ayumi Kaneuji, Eiji Takahashi","doi":"10.1177/11207000241300061","DOIUrl":"10.1177/11207000241300061","url":null,"abstract":"<p><strong>Purpose: </strong>This study introduces a new technique, spherical periacetabular osteotomy (SPO), performed via a para-sartorial intermuscular (PSIM) approach with a bikini incision, aiming to optimise the benefits of SPO, including preservation of muscles and providing cosmetic advantages.</p><p><strong>Methods: </strong>Overall, 57 joints of 52 patients (mean age 36 ± 17 years) underwent SPO via the PSIM approach. Preoperative osteoarthritis was classified according to Tönnis grade, with 34 and 23 hips categorised as grades 0 and 1, respectively.</p><p><strong>Results: </strong>The modified Harris Hip Scores significantly improved from 75 ± 10 to 96 ± 8 points at 6 months postoperatively. The lateral centre-edge angle improved from 6 ± 8° preoperatively to 30 ± 8° postoperatively, with a mean correctional angle of 24 ± 9°. Paresthetica of the lateral femoral cutaneous nerve occurred in 7 joints (12.3%) 3 months postoperatively. All cases except 1 achieved bone union within 3 months, and a nonunion case required additional surgery.</p><p><strong>Conclusions: </strong>Although the long-term results are not yet available, SPO via the PSIM approach demonstrates promising outcomes without significant complications. Furthermore, using the PSIM approach with a bikini incision has the advantages of muscle preservation and excellent cosmesis, which are delighted for young patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"198-204"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do children <3years at index surgery for DDH have a better outcome at mid-term follow-up in comparison to children >3years at index surgery? A prospective comparative study.","authors":"Vivek Singh, Aditya Ks Gowda, Cury Sharma, Chanakya Pv, Mohit Dhingra, Pankaj Kandwal, Vikas Maheshwari","doi":"10.1177/11207000241303687","DOIUrl":"10.1177/11207000241303687","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis and management of developmental dysplasia of hip (DDH) in underdeveloped regions is frequently delayed, potentially impacting final outcomes. This prospective study was conducted with the aim of answering the question, \"Do children <3 years at index surgery for DDH have better outcome at 5-year follow-up in comparison to children >3 years at index surgery?\"</p><p><strong>Methods: </strong>Between 2016 and 2021, all walking-age children with DDH were prospectively enrolled in the study. The study cohort was divided into 2groups: Group 1 ⩽3 years of age, and Group 2 included children >3 years old. Intraoperative decisions determined the need for addition of femoral or pelvic osteotomy to the open reduction (OR). Follow-up assessment and group comparison included acetabular-index (AI), proximal femoral growth disturbances (PFGD), and outcomes based on Severin's criteria. Subgroup analysis also compared re-dislocated hips with stable hips post-surgery. Children with follow-ups <3 years were excluded.</p><p><strong>Results: </strong>45 hips in 38 children analysed (31 in Group 1 and 14 in Group 2). Group 1 had higher pre-op AI (<i>p</i> <i>=</i> 0.0489). More hips in Group 2 underwent OR with femoral osteotomy (<i>p</i> <i>=</i> 0.0016). Re-dislocation occurred in 6 (19%) in Group 1 and 2 (14%) in Group 2. Subgroup analysis revealed higher index postoperative AI in re-dislocated hips (<i>p</i> <i>=</i> 0.0001). At the final follow-up, AI was similar between Groups 1 and 2 (<i>p</i> <i>=</i> 0.27). Overall, satisfactory outcomes were comparable between Groups 1 and 2 (<i>p</i> <i>=</i> 0.21). PFGD changes were significantly higher in Group 2 (<i>p</i> <i>=</i> 0.028) and in re-dislocated hips (<i>p</i> <i>=</i> 0.004). Satisfactory outcomes were found in 89% of non-re-dislocated hips and 75% of re-dislocated hips.</p><p><strong>Conclusions: </strong>At an average follow-up of 5 years, children above and below 3 years at index procedure for DDH show similar outcomes but older ones need femoral osteotomy more frequently. Osteonecrosis risk rises with increasing age at index surgery and after re-operations, but its impact is not clear in mid-term.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"205-213"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative gait parameters in hip resurfacing compared to total hip arthroplasty: a systematic review.","authors":"Ali Parsa, Tracy George, Rachel Bruning, Paulo Padilla, Mark F Schinsky, Benjamin G Domb","doi":"10.1177/11207000251321765","DOIUrl":"https://doi.org/10.1177/11207000251321765","url":null,"abstract":"<p><strong>Introduction: </strong>In the past decade, an increasing number of younger, active patients, including athletes, sought hip resurfacing (HR) arthroplasties. Some literature has suggested that hip resurfacing may allow faster recovery, better postoperative range of motion, and reduced risk for dislocation compared to total hip arthroplasty (THA). The purpose of the present systematic review was to study the variations in postoperative gait parameters among patients with hip osteoarthritis who have undergone hip resurfacing or THA.</p><p><strong>Methods: </strong>According to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), a literature search was conducted in October 2022 for \"hip resurfacing\" OR \"hip arthroplasty\" AND \"gait\".</p><p><strong>Results: </strong>8 studies with 206 patients (273 hips) were included in the analysis. The mean age of patients ranged from 44.4 to 67 years. On average of all studies, 54.3% of the patients were male and 45.7% female. Among all patients undergoing HR and THA, there were comparable numbers of males in each group (range 58.3-82.1% and 60.0-88.9%, respectively). 6 studies indicated that hip resurfacing patients reached a greater average walking speed, average stride lengths, stance times, and ability to perform uphill walking. 3 studies showed similar outcomes in flat surface walking between hip resurfacing and total hip arthroplasty patients.</p><p><strong>Conclusions: </strong>Little data are available to compare gait parameters in HR and THA. Some studies suggest that HR might have advantages in the gait and walking parameters like a greater average walking speed, average stride lengths, stance times, and ability to perform uphill walking, energy expenditure and better peak extension moment.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251321765"},"PeriodicalIF":1.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctor when can I drive? A systematic review and meta-analysis of brake reaction time in patients returning to driving after hip arthroscopy for femoroacetabular impingement (FAI).","authors":"Ravi Patel, Balamrit Singh Sokhal, Carl Fenton, Daniel Omonbude, Robin Banerjee, Rajpal Nandra","doi":"10.1177/11207000251321345","DOIUrl":"https://doi.org/10.1177/11207000251321345","url":null,"abstract":"<p><strong>Background: </strong>A common question from patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) is when they may return to driving.</p><p><strong>Purpose: </strong>We aimed to perform a formal systematic review and meta-analysis to address this issue.</p><p><strong>Methods: </strong>A systematic review and meta-analysis followed PRISMA guidelines. Databases searched included OVID, EMBASE, and COCHRANE through July 2024 for articles with keywords and MeSH terms like \"Hip arthroscopy,\" \"Femoroacetabular Impingement,\" \"total brake response time,\" and \"reaction time\" related to driving. Titles and full articles were reviewed for quality and relevance. Statistical analysis was done using Review Manager Version 5.4.A total of 39 articles were reviewed, with 5 meeting inclusion criteria. All selected articles used brake reaction time (BRT) as an outcome measure. A meta-analysis compared pre- and postoperative BRT values. Data were analysed for the right and left hips combined, followed by a subgroup analysis by laterality. BRT values were divided into preoperative and 2, 4, 6, and 8 weeks postoperative periods.</p><p><strong>Results: </strong>The studies assessed 160 patients, with 142 undergoing hip arthroscopy for FAI. The mean age was 32.75 ± 9.4 years, with a male-to-female ratio of 73:69. The right hip was affected in 68% of patients. Preoperative BRT ranged from 566 to 1960 milliseconds, while postoperative BRT ranged from 567 to 1860 milliseconds between week 2 and week 12.</p><p><strong>Conclusions: </strong>BRTs returned to baseline or control values and continued to improve 4 weeks post-surgery for FAI. It is safe to recommend a return to driving at 4 weeks after hip arthroscopy for FAI.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251321345"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe acetabular bone loss management: is there still a role for titanium cages and cemented cups?","authors":"Loris Perticarini, Luca Andriollo, Stefano M P Rossi, Rudy Sangaletti, Francesco Benazzo","doi":"10.1177/11207000251315837","DOIUrl":"https://doi.org/10.1177/11207000251315837","url":null,"abstract":"<p><strong>Introduction: </strong>Bone loss represents a formidable challenge in hip revision surgery. Recent advances in revision implants and the use of new materials have diminished the need for cup-cages in addressing severe acetabular bone loss, which, however, may still be indicated in certain situations. The objectives of this study are to assess survival, functional outcomes, and reasons for the failure of managing severe acetabular bone loss with titanium cages and cemented cup.</p><p><strong>Methods: </strong>57 patients treated with an acetabular cage and cemented cup for acetabular revision between January 2014 and July 2018 were retrospectively evaluated. Inclusion criteria comprised cup loosening with bone loss greater than IIB according to Paprosky classification, and a follow-up of at least 60 months.</p><p><strong>Results: </strong>The average age at the time of surgery was 74.8 years (SD 10.7). The acetabular bone defect according to the Paprosky classification was: type II C in 10 patients (21.7%), type III A in 21 patients (45.7%) and type III B in 15 patients (32.6%). Pelvic discontinuity was present in 35 cases (76.1%). The average follow-up during the final assessment was 78.3 months (SD 14.9). The reoperation rate was 13% (6 patients) and the complications rate was 17.4%. The survivorship of the implant was 87% at final follow-up.At the final follow-up average HHS was 89.4 ± 13.4, average WOMAC 15.7 ± 17.2, average HOOS 81.3 ± 19 and average FJS-12 83.7 ± 17.2. At the final follow-up, 32 patients (80%) showed excellent or good outcomes (HHS >80).</p><p><strong>Conclusions: </strong>In the presence of severe bone defects, acetabular reconstruction using titanium acetabular cages and cemented UHMWPE cups remains a valid treatment option. Specifically, this acetabular reconstruction system should be favoured for elderly or low-demand patients, with the possibility of using it safely even in patients with pelvic discontinuity.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251315837"},"PeriodicalIF":1.3,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low rates of dislocation and reoperation following robotic-assisted total hip arthroplasty for femoral neck fracture.","authors":"Jeffrey A O'Donnell, Daniel B Buchalter, Tracy M Borsinger, Sonia K Chandi, Colin C Neitzke, Geoffrey H Westrich, Elizabeth B Gausden","doi":"10.1177/11207000241312385","DOIUrl":"https://doi.org/10.1177/11207000241312385","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is widely used for active, elderly patients with femoral neck fractures (FNF). Compared to THA for osteoarthritis, THA for FNF is associated with a higher incidence of dislocation and reoperation. Robotic assistance may improve component positioning and leg-length restoration in THA, but its use in FNF has not been described. The objective of this study was to assess the feasibility and perioperative outcomes of robotic-assisted THA (rTHA) for FNF.</p><p><strong>Methods: </strong>A retrospective review identified 93 patients undergoing 94 THAs for FNF from 2016 to 2023. 18 patients treated with MAKOplasty rTHA were compared to 76 non-rTHA. There were 69 (73%) women, the mean age was 71 years, and the mean follow-up was 3 years.</p><p><strong>Results: </strong>There was no significant difference in operative time between rTHA and non-rTHA cohorts (100 vs. 108 minutes, <i>p</i> = 0.19), and sub-analysis of acute FNFs (< 6 weeks), showed no difference in the meantime from presentation to surgery (18 vs. 25 hours, <i>p</i> = 0.24). There was no significant difference in mean leg-length discrepancy (LLD) (<i>p</i> = 0.19), number of outliers for acetabular anteversion (<i>p</i> = 0.80), or inclination (<i>p</i> = 0.55). There were no postoperative dislocations or reoperations in the rTHA cohort, compared to 4 dislocations (5%) and 6 reoperations (8%) in the non-rTHA cohort (<i>p</i> = 1.00 and 0.59, respectively).</p><p><strong>Conclusions: </strong>In this series of THA for FNF, robotic assistance did not significantly delay the time to surgery or increase the operative time compared to non-rTHA. At a mean follow-up of 3 years, there were no postoperative dislocations or reoperations in the rTHA cohort.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000241312385"},"PeriodicalIF":1.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 'Quartered Head Technique': a simple, reliable way of maintaining leg length and offset during total hip arthroplasty.","authors":"Oluwatobi O Onafowokan, Muhammad Haruna, Alasdair R Bott, Ewan Bigsby, Rory G Middleton, Gavin Holt","doi":"10.1177/11207000241302471","DOIUrl":"10.1177/11207000241302471","url":null,"abstract":"<p><strong>Introduction: </strong>Various techniques have been described for restoring leg length and offset during total hip arthroplasty (THA). We herein describe a novel \"Quartered Head Technique\" (QHT) involving a series of femoral osteotomies.</p><p><strong>Methods: </strong>124 hips were included in the analysis. An anterolateral approach was used in all cases. Leg length, and offset were assessed intraoperatively and reproduced using the QHT. A leg-length discrepancy (LLD) of <6 mm was chosen as acceptable based on previously published literature. Postoperative pelvic radiographs were assessed by two independent observers to ensure inter-observer reliability.</p><p><strong>Results: </strong>The mean absolute postoperative difference in leg length from the contralateral leg was +3.58 mm. 84% of patients had LLD within ±6 mm of the contralateral limb. Mean absolute postoperative difference in offset from the contralateral leg was +3.88 mm. 90% of patients were within ±6 mm offset of the contralateral limb. There was no statistical difference noted between observer measurement.</p><p><strong>Conclusions: </strong>The QHT provides a simple, inexpensive, yet effective method of maintaining femoral leg length and offset during total hip arthroplasty.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"33-40"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes associated with hip preservation using osteochondral allograft transplants and acetabular labrum reconstruction.","authors":"Kylee Rucinski, James L Cook, Cory R Crecelius, Brett D Crist","doi":"10.1177/11207000241288445","DOIUrl":"10.1177/11207000241288445","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral allograft (OCA) transplantation with or without labral reconstruction is considered a hip preservation surgical treatment option for young, active patients. This study aims to report early outcomes for use of OCA and labrum allograft transplants for patients treated for symptomatic femoral head chondral damage and/or acetabular labrum deficiency after implementation of a comprehensive joint restoration approach.</p><p><strong>Methods: </strong>33 patients from a lifelong registry were included for analysis. Outcomes were compared for statistically significant (<i>p</i> < 0.05) differences based on graft preservation methodology (standard preservation [SP] vs. Missouri Osteochondral Preservation System [MOPS]), and based on surfaces treated (femoral head only, labrum only, or femoral head and labrum).</p><p><strong>Results: </strong>Mean follow-up duration was 44.8 (range 12-95) months. Success was documented in 28 (84.8%) patients. For the SP cohort, successful outcomes were documented in 5 cases (50%), while all 23 MOPS cases (100%) were deemed successful at least 1 year after surgery. Hip preservation surgeries performed using MOPS grafts were associated with significantly (<i>p</i> = 0.001; OR = 47x) higher success rates, including significant and clinically meaningful improvements in PROMs at 1 and 2 years after surgery. Revision was performed in 2 patients in the SP cohort and failure requiring total hip arthroplasty was documented in 3 SP patients. Mean time to revision or failure was 23.6 (range 4-43) months. The surfaces treated were significantly associated with failure when comparing patients undergoing a femoral head OCA with or without labral reconstruction to those undergoing labral reconstruction only (<i>p</i> = 0.03; OR = 8.3x).</p><p><strong>Conclusions: </strong>Patients with symptomatic femoral head cartilage loss and/or irreparable acetabular labrum deficiency undergoing femoral head OCA transplantation and/or labral reconstruction with meniscus allografts using MOPS-preserved tissues experienced statistically significant and clinically meaningful improvements in pain and function through at least 2 years after surgery.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"9-17"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse spinopelvic mobility in patients undergoing total hip arthroplasty is associated with high mobility of the hip in a flexed seated position.","authors":"Thomas Aubert, Aurelien Halle, Philippe Gerard, Guillaume Riouallon, Guillaume Auberger, Luc Lhotellier","doi":"10.1177/11207000241284260","DOIUrl":"10.1177/11207000241284260","url":null,"abstract":"<p><strong>Purpose: </strong>Adverse spinopelvic mobility from a standing to a flexed seated position of more than 20° of the spinopelvic tilt (∆SPT) has been shown to have a high risk of dislocation. If hypermobility of the hip analysed with the pelvic femoral angle (∆PFA) has a high risk of impingement, the correlation between the range of motion of the hip from a standing to a flexed seated position and its implication in adverse spinopelvic mobility has not been described.</p><p><strong>Methods: </strong>A series of 337 patients treated with primary THA underwent lateral x-ray in standing and flexed seated positions to analyse ∆SPT, ∆PFA and spinopelvic parameters. The objectives were to establish a ∆PFA threshold associated with a ∆SPT ⩾20° and to subsequently investigate its influence in conjunction with spinopelvic risk factors on the occurrence of adverse spinopelvic mobility.</p><p><strong>Results: </strong>The area under the curve was 0.904 (95%CI, 0.864-0.945) for ∆PFA to predict ∆SPT ⩾ 20°; it was predicted by ∆PFA ⩾ 95° with a sensitivity of 91.7% and a specificity of 74.4% at the Youden optimal threshold. Patients with a ∆SPT < 20° (277 patients) had a mean ∆PFA of 83° compared to 110° if ∆SPT ⩾ 20° (60 patients) (<i>p</i> < 0.001). Patients with a ∆PFA < 95° (203 patients) had a mean ∆SPT of -6° compared to 18° if ∆PFA ⩾ 95° (134 patients) (<i>p</i> < 0.001). ∆PFA ⩾ 95° rates were 95% (57/60) and 27.8% (77/200) in patients with ∆SPT ⩾ 20° and ∆SPT < 20°, respectively (OR 49.35; CI, 15.01-162.28; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>High mobility of the hip (∆PFA ⩾ 95°) seems to be a necessary condition for adverse spinopelvic mobility. A preoperative analysis of patients with lower hip mobility, associated with spinopelvic risk factors, might identify patients with abnormal spinopelvic mobility after the restoration of femoral flexion.</p><p><strong>Trial registration: </strong>IDRCB 2023-A01390, CNIL MR004 2225508 (07/06/2023), retrospectively registered.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"47-53"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and radiological outcomes and complications of Bernese periacetabular osteotomy through modified Stoppa approach.","authors":"Deniz Akbulut, Mehmet Coskun","doi":"10.1177/11207000241280951","DOIUrl":"10.1177/11207000241280951","url":null,"abstract":"<p><strong>Background: </strong>The Smith-Peterson approach and its modifications provide an extensive exposure and allow osteotomies through a single incision. However, the risk of complications increases when the quadrilateral surface, ischial and pubic osteotomy sites cannot be seen. This study aimed to evaluate the surgical characteristics, complications, and functional and radiological outcomes of patients with acetabular dysplasia who underwent Bernese periacetabular osteotomy (PAO) through modified Stoppa approach and plate-screw fixation.</p><p><strong>Methods: </strong>The study included 31 patients (41 hips) who had undergone PAO using a modified Stoppa approach. The characteristics of patients and the surgical procedure were described. The lateral centre-edge angle (LCEA) and Tönnis roof angle were evaluated in the radiological outcome evaluation. The modified Harris Hip Score (mHHS) was used to evaluate functional outcome. Furthermore, complications were described.</p><p><strong>Results: </strong>The mean age of the patients was 20.4 ± 9.0 years. Of the 31 patients, 21 underwent unilateral Bernese PAO and 10 underwent bilateral Bernese PAO. The mean follow-up period was 25.1 ± 8.8 months. Postoperatively, the mean mHHS improved significantly (68.8 ± 9.4 vs. 88.8 ± 10.0, <i>p</i> < 0.001). Postoperatively, the mean LCEA and Tönnis roof angle improved significantly (17.7 ± 6.0 vs. 42.2 ± 4.8, <i>p</i> < 0.001 for LCEA and 18.3 ± 5.5 vs. 8.0 ± 2.2, <i>p</i> < 0.001 for Tönnis roof angle). There was no significant correlation between preoperative to postoperative improvement in LCEA or Tönnis roof angle and improvement and mHHS (<i>p</i> > 0.005). 5 complications were identified: 1 transient sciatic nerve palsy, 1 external iliac vein injury, 1 infection, and 2 screw irritations of acetabulum.</p><p><strong>Conclusions: </strong>Performing Bernese PAO through a modified Stoppa approach with plate-screw fixation results in acceptable complication rates, immediate early weight-bearing opportunity, and improved functional and radiological outcomes in patients with acetabular dysplasia.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"83-91"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}