Pelvic Osteotomies for Treatment of Young Patients With Hip Osteoarthritis Secondary to Developmental Dysplasia

Abstract

Background. The value of joint-sparing reconstructive procedures in patients with osteoarthritis in a dysplastic hip is controversial. The study aimed to evaluate the immediate and mid-term results of reconstructive interventions performed in patients with this pathology. Methods. The treatment results of 30 patients aged 1440 years with osteoarthritis in the dysplastic hip were analyzed. The mean follow-up time was 6.81.5 years in group 1 and 4.10.7 years in group 2. The clinical condition and treatment results were assessed by DAubigne-Postel, Severin, Tonnis criteria, and the Ilizarov Center system. In all cases, extra-articular reconstructive procedures were performed on both articular components. Results. The patients were divided into two groups by age. In group 1 (1418 years), the functional result was 16.00.5 points. According to the Severin criteria, the joints were distributed as follows: Ia, 7; IIa, 7; IIb, 2; and III, 3. The degree of hip osteoarthritis did not change in 13 joints. Osteoarthritis progressed in one joint, and arthritic changes regressed in four joints. The treatment results according to the criteria of the RSC VTO were good in 14 joints, satisfactory in 5, and unsatisfactory in 1. In group 2 (18 years, n = 11), the functional result was 15.00.4 points. The distribution of joints according to the Severin criteria was as follows: Ia, 3; IIa, 6, and III, 2. The degree of osteoarthritis did not change in 10 joints. Osteoarthritis progressed in one joint. The treatment results according to the criteria of the Ilizarov Center were good in seven joints, satisfactory in three, and unsatisfactory in one. Conclusions. The differentiated use of joint-sparing reconstructive procedures makes it possible to slow down the progression of the pathological process in the joint even in patients with developed osteoarthritis and, in some cases, to use them as a temporary alternative to endoprosthesis in adolescents and young adults.