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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(04): e639-e645
DOI: 10.1055/s-0043-1772242
Artigo Original
Ortopedia Pediátrica

Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease?

Artikel in mehreren Sprachen: português | English
Nitish Bikram Deo 
1   Médico Ortopedista, Hospital Universitário Tribhuvan, Maharajgunj Medical Campus, Instituto de Medicina, Maharajgunj, Kathmandu, Nepal
,
Anil Agarwal 
2   Médico Ortopedista, Departamento de Ortopedia Pediátrica, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, IÍndia
› Institutsangaben Financial Support This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Objective We investigated the effect of disease stage, patient's age and final contour of femoral head on acetabulum contour following varus derotation osteotomy of proximal femur (VDRO) in unilateral Perthes's disease.

Methods The study is a retrospective analysis of case records of 23 children aged ≥6 years with unilateral Perthes' disease who underwent primary VDRO procedure for containment. Acetabular index (AI) and center edge angle (CEA) were calculated bilaterally in preoperative and follow-up radiographs and compared statistically.

Results There were 15 boys and 8 girls. Six hips were in Ib, 8 in IIa and 9 in IIb modified Waldenström stage while undergoing VDRO. The mean age at surgical intervention was 8.7 years. The mean follow-up duration was 3.5 years. All femoral heads were healed at final follow-up and the final Stulberg grades were I = 3, II = 8, III = 7, IV = 5. A significant acetabular dysplasia on the affected side was present preoperatively. At follow-up, the patients operated had significantly raised AI and reduced CEA. There was no significant acetabular remodeling of the affected hips at follow-up even in children operated at younger age (< 8 years) or early stages (stage Ib or IIa). The acetabulum remodeling did not correspond to the final Stulberg grade as well.

Conclusion Acetabulum was found involved in early stages of Perthes' disease. Varus derotation femoral osteotomy for the diseased hip showed no significant improvement in acetabular dysplasia even when operated in early disease stages or younger age group. Residual acetabular changes were also noted even with favorable Stulberg grades.

Keywords

acetabulum - child - hip joint - legg-calve-perthes disease

Authors' Contributions

Each author contributed individually and significantly to the development of this article: NBD: Methodology, investigation, writing original draft; AA: conceptualization, supervision, editing.


Work developed in the Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India




Publikationsverlauf

Eingereicht: 12. März 2023

Angenommen: 05. Mai 2023

Artikel online veröffentlicht:
30. August 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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