Long-term Results of Modified Salter Innominate Osteotomy for Legg-Calvé-Perthes Disease. 2017

Kyung Soon Park, and Kyu Jin Cho, and Hong Yeol Yang, and Kamolhuja Eshnazarovich Eshnazarov, and Taek Rim Yoon
Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea.

BACKGROUND In a previous study, we reported clinical and radiographic results of our modified Salter innominate osteotomy technique in 16 hips affected by Legg-Calvé-Perthes disease (LCPD) with an average follow-up of 31.8 months. In this study, we present the long-term results of the osteotomy in LCPD patients followed until physeal closure. METHODS Thirty hips of 29 patients were followed until skeletal maturation after modified Salter innominate osteotomy. The mean follow-up duration was 12.9 years (range, 9.1 to 16.0 years). Eleven hips (36.7%) were classified as Catterall group III and 19 (63.3%) as Catterall group VI. Stable interposition of a bone block was achieved using one biodegradable screw in nine hips and without any fixation device in 21 hips by simply changing the direction of osteotomy. The Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and hip function were evaluated at the last follow-up. Radiological outcomes were evaluated using Wiberg's center-edge angle, the Mose method, and Stulberg classification, and osteoarthritic changes were evaluated using the Tonnis classification. RESULTS Mean HHS and WOMAC score were 80.2 points and 54 points, respectively, preoperatively and these were improved to 96.2 points and 28 points, respectively, at the last follow-up. Clinical results, according to Robinson's criteria, were good in 18, fair in seven, and poor in five hips. Radiological results assessed using the Mose method were good in 18, fair in six, and poor in six hips, and according to the Stulberg classification, nine hips were class I, nine were class II, eight were class III, and four were class IV. The mean center-edge angle improved from 19.7° preoperatively to 29.6° at the final follow-up. According the Tonnis classification, three hips were grade 2, five were grade 1, and 22 were grade 0. Of the three grade 2 hips, two underwent Chiari osteotomy 12.1 and 8.8 years postoperatively, and the other underwent total hip arthroplasty 12.9 years postoperatively. CONCLUSIONS The modified Salter innominate osteotomy produced relatively satisfactory long-term clinical and radiological results.

UI MeSH Term Description Entries
D007873 Legg-Calve-Perthes Disease A particular type of FEMUR HEAD NECROSIS occurring in children, mainly male, with a course of four years or so. Coxa Plana,Legg-Perthes Disease,Perthes Disease,Legg-Calve-Perthes Syndrome,Legg-Calvé-Perthes Disease,Legg-Calvé-Perthes Syndrome,Osteochondritis Deformans,Disease, Legg-Calve-Perthes,Disease, Legg-Calvé-Perthes,Disease, Legg-Perthes,Disease, Perthes,Legg Calve Perthes Disease,Legg Calve Perthes Syndrome,Legg Calvé Perthes Disease,Legg Calvé Perthes Syndrome,Legg Perthes Disease,Osteochondritis Deforman,Syndrome, Legg-Calve-Perthes,Syndrome, Legg-Calvé-Perthes
D008297 Male Males
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D001846 Bone Development The growth and development of bones from fetus to adult. It includes two principal mechanisms of bone growth: growth in length of long bones at the epiphyseal cartilages and growth in thickness by depositing new bone (OSTEOGENESIS) with the actions of OSTEOBLASTS and OSTEOCLASTS. Bone Growth
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip

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