Key result
Chiari osteotomy and shelf procedures for residual hip dysplasia generally achieved less than complete cover, especially over the posterolateral quadrant of the femoral head.
Why the study?
What is the extent of acetabular cover achieved by Chiari osteotomy and shelf procedures in patients with residual hip dysplasia?
Observational (n=32)
What is the extent of acetabular cover achieved by Chiari osteotomy and shelf procedures in patients with residual hip dysplasia?
Augmentation procedures for hip dysplasia often provide incomplete coverage, suggesting alternative methods that reorient the whole acetabulum are preferable.
Augmentation procedures yield inferior articular surfaces with incomplete coverage; leaves open need for superior options in acetabular dysplasia.
The Chiari osteotomy and various shelf procedures are used to augment the weight-bearing area in dysplastic acetabula. The new articular surface derives by metaplasia from the acetabular rim and joint capsule, and is therefore of poorer quality than congruous hyaline cartilage. We reviewed 32 patients after augmentation procedures, using conventional radiographs and three-dimensional reconstruction from CT scans. We showed that Chiari osteotomy and shelf procedures generally achieve less than complete cover, especially over the posterolateral quadrant of the femoral head. Our results suggest that alternative methods which reorientate the whole of the acetabulum are the treatment of choice. Augmentation procedures remain as a salvage option when reorientation is inappropriate or the original hyaline cartilage surface is absent, as in subluxed joints with a secondary acetabulum. Computerised assessment is recommended before operation to assess existing cover and the possible extent of provision of new cover.
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Klaue et al. (1993) conducted an observational in Residual hip dysplasia (n=32). Chiari osteotomy and shelf procedures was evaluated on Radiological assessment of acetabular cover. Chiari osteotomy and shelf procedures for residual hip dysplasia generally achieved less than complete cover, especially over the posterolateral quadrant of the femoral head.
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