Result of Shelf Acetabuloplasty in Adults: 20 Years of Follow-Up
Abstract
The current study was conducted in order to examine the effectiveness of shelf procedure in symptomatic adult patients due to hip dysplasia. This study is retrospective and was performed on patients who had undergone surgery by one orthopaedic surgical team during the past 20 years. Twenty-three men and twenty-three women were enrolled in the study with a mean age of 29.3 years at the time of operation and they were followed up for a mean of 9.3 years. Shelf acetabuloplasty was performed unilateral in 30 patients and bilateral in 16 patients. Results demonstrated that mean Harris Hip Score and CE Angle significantly improved after the operation, while osteoarthritis got more severe post-operatively. The severity of osteoarthritis and the Harris Hip Score respectively significantly increased and decreased 14 years after the operation. Results also demonstrated that as the age of the patient was less, and the patient was more satisfied and the degree of osteoarthritis was less at the time of the operation, the mean change of the Harris Hip Score would be higher and the results of the operation would be more favorable. The preoperative osteoarthritis was significantly worse in to-be-operated hips than their control hips, this difference was not significant after the operation. And finally, although Harris Hip Score has been lower in to-be-operated hips before the operation, it was higher in these very same hips than the control hips after the operation. In short, according to this study although the shelf acetabuloplasty is a salvage procedure and cannot cover the femoral head concentrically like the modern redirectional osteotomies , but it is an effective procedure for a young patient to postpone the progression of the hip osteoarthritis (OA) once it occurs in order to perform reconstructive surgeries later when justified.
Aronsson DD, Goldberg MJ, Kling TF Jr, Roy DR. Developmental dysplasia of the hip. Pediatrics 1994; 94(2 Pt 1):201-8. Erratum in: Pediatrics 1994;94(4 Pt 1):470.
Haynes RJ. Developmental dysplasia of the hip: etiology, pathogenesis, and examination and physical findings in the newborn. Instr Course Lect 2001;50:535-40.
Dormans JP. Pediatric Orthopaedics and Sports Medicine the Requisites in Pediatrics. St. Louis: Mosby; 2004.
Summers BN, Turner A, Wynn-Jones CH. The shelfoperation in the management of late presentation of congenital hip dysplasia. J Bone Joint Surg Br1988;70(1):63-8.
Benson MK, Evans DC. The pelvic osteotomy of Chiari:an anatomical study of the hazards and misleading radiographic appearances. J Bone Joint Surg Br 1976;58(2):164-8.
Solomon L, Schnitzler CM. Pathogenetic types of coxarthrosis and implications for treatment. Arch Orthop Trauma Surg 1983;101(4):259-61.
Harris WH, editor. The Hip: Proceedings of the Second Open Scientific Session of the Hip Society. St. Louis: CV Mosby; 1974.
Lievense AM, Bierma-Zeinstra SM, Verhagen AP, Verhaar JA, Koes BW. Influence of hip dysplasia on the development of osteoarthritis of the hip. Ann Rheum Dis 2004;63(6):621-6.
Chiari K. Medial displacement osteotomy of the pelvis. Clin Orthop Relat Res 1974;(98):55-71.
Konig, F. Osteoplastische behandlung der kongenitalen hueftgelensluxation (mit demonstration eines pareparates. Verh Dtsch Ges Chir 1891;20:75-80.
Gill B. Operation for old congenital dislocation of the hip. Surg Clin North Am 1926;6:147-53.
Wiberg G. Shelf operation in congenital dysplasia of the acetabulum and in subluxation and dislocation of the hip. J Bone Joint Surg Am 1953;35-A(1):65-80.
Staheli LT, Chew DE. Slotted acetabular augmentation in childhood and adolescence. J Pediatr Orthop 1992;12(5):569-80.
Summers BN, Turner A, Wynn-Jones CH. The shelf operation in the management of late presentation of congenital hip dysplasia. J Bone Joint Surg Br 1988;70(1):63-8.
White RE Jr, Sherman FC. The hip-shelf procedure. A long-term evaluation. J Bone Joint Surg Am 1980;62(6):928-32.
Courtois B, Le Saout J, Lefèvre C, Kerboul B, Roblin L, Miroux D, Lagdani R. The shelf operation for painful hip dysplasia in adults. Apropos of a continuous series of 230 cases. Int Orthop 1987;11(1):5-11.
Love BR, Stevens PM, Williams PF. A long-term review of shelf arthroplasty. J Bone Joint Surg Br 1980;62(3):321-5.
Migaud H, Chantelot C, Giraud F, Fontaine C, Duquennoy A. Long-term survivorship of hip shelf arthroplasty andChiari osteotomy in adults. Clin Orthop Relat Res 2004;(418):81-6.
DeMourgues G, Patte D. Résultats, après au moins 10 ans, des ostéotomies d’orientation du col du fémur dans les coxarthroses secondaires peu évoluées chez l’adulte: symposium. Rev Chir Orthop 1978;64:525-605.
Bickel WH, Breivis JS. Shelf operation for congenital subluxation and dislocation of the hip. Clin Orthop Relat Res 1975;(106):27-34.
Fawzy E, Mandellos G, De Steiger R, McLardy-Smith P, Benson MK, Murray D. Is there a place for shelf acetabuloplasty in the management of adult acetabular dysplasia? A survivorship study. J Bone Joint Surg Br 2005;87(9):1197-202.
Rosset P, Heudel B, Laulan J, Garaud P, Favard L. Longterm evolution following shelf procedure for hip dysplasia in adults. Shelf survival analysis in 68 cases and retrospective review of 44 with at least 26 years follow-up. Acta Orthop Belg 1999;65(3):315-26.
Girard J, Springer K, Bocquet D, Cotten A, Duquennoy A, Migaud H. Influence of labral tears on the outcome of acetabular augmentation procedures in adult dysplastic hips. Prospective assessment with a minimum follow-up of 12 years. Acta Orthop Belg 2007;73(1):38-43.
Pompe B, Antolic V. Slotted acetabular augmentation for the treatment of residual hip dysplasia in adults: early results of 12 patients. Arch Orthop Trauma Surg 2007;127(8):719-23.
Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. J Bone Joint Surg Br 1991;73(3):423-9.
Nishina T, Saito S, Ohzono K, Shimizu N, Hosoya T, Ono K. Chiari pelvic osteotomy for osteoarthritis. The influence of the torn and detached acetabular labrum. J Bone Joint Surg Br 1990;72(5):765-9.
Files | ||
Issue | Vol 49, No 8 (2011) | |
Section | Original Article(s) | |
Keywords | ||
Shelf acetabuloplasty Hip dysplasia Hip osteoarthritis Salvage procedure |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |