Comparison of Salter innominate osteotomy and Pemberton pericapsular osteotomy combined with open reduction through medial adductor approach on acetabular development in the treatment of developmental hip dysplasia

Abstract

Objective: Combined with open reduction through medial adductor approach, Salter innominate osteotomy (SIO) and Pemberton pericapsular osteotomy (PPO) methods are common procedures for the repair of incomplete acetabulum structure in patients with developmental hip dysplasia (DHD). The aim of this study is to compare the outcomes of acetabulum development in patients treated using these two methods. Patients and Methods: We retrospectively reviewed the medical records of 50 (65 hip joints) children who underwent SIO or PPO for DHD. Thirty-three patients underwent SIO and 32 patients underwent PPO as surgical treatment. The criteria of Tönnis, modified McKay, and Severin, and angles of acetabular index (AI) and acetabular center-edge (CE) angles of both groups were compared. Results: There were significant differences between two groups in the time of operation, follow-up time after operation, preoperative and postoperative AI angles, and postoperative 1styear CE angles. AI was detected as lower in the PPO group at 1stmonth postoperatively. Whereas, mean AI was detected as higher in the preoperative PPO group. In addition, the acetabular CE angle was significantly lower in the PPO group at 1styear postoperatively. However, there was no significant difference between the groups in terms of the CE angle value measured at the final follow-up. Conclusion: Salter innominate osteotomy and PPO methods used in the treatment of DHD have specific advantages and disadvantages. Preoperative and intraoperative evaluations of patients are very important in determining which procedure should be performed. When the choice is made properly, clinical and radiological results are both satisfactory.