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Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease?
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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Revinter Publicações Ltda.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468242/ https://www.ncbi.nlm.nih.gov/pubmed/37663180 http://dx.doi.org/10.1055/s-0043-1772242 |
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author | Deo, Nitish Bikram Agarwal, Anil |
author_facet | Deo, Nitish Bikram Agarwal, Anil |
author_sort | Deo, Nitish Bikram |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10468242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Thieme Revinter Publicações Ltda. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104682422023-09-01 Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? Deo, Nitish Bikram Agarwal, Anil Rev Bras Ortop (Sao Paulo) 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. Thieme Revinter Publicações Ltda. 2023-08-30 /pmc/articles/PMC10468242/ /pubmed/37663180 http://dx.doi.org/10.1055/s-0043-1772242 Text en 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/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Deo, Nitish Bikram Agarwal, Anil Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? |
title | Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? |
title_full | Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? |
title_fullStr | Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? |
title_full_unstemmed | Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? |
title_short | Does Acetabulum Remodel Following Varus Derotation Osteotomy for Perthes' Disease? |
title_sort | does acetabulum remodel following varus derotation osteotomy for perthes' disease? |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468242/ https://www.ncbi.nlm.nih.gov/pubmed/37663180 http://dx.doi.org/10.1055/s-0043-1772242 |
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