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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
BONE AND JOINT DEFORMITIES - SCIENTIFIC PAPERS 100° CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPAEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Pavia, June 20-21, 2003
Minerva Ortopedica e Traumatologica 2003 April;54(2):107-10
Total hip replacement after pelvic osteotomy
Cabitza P., Randelli F., Parrini M., Randelli P., Azzoni R., Randelli G.
V Clinica Ortopedica, Università degli Studi di Milano, Istituto Policlinico San Donato, San Donato Milanese (MI)
During the last decades of the past century osteotomic surgery of the pelvis and proximal femur has been frequently performed in the treatment of hip dysplasia, mainly due to serious concern related to life expectancy of prosthetic implants. Pelvic osteotomies (such as the Chiari’s procedure) as well as femur osteotomies (such as valgus-extension according to Bombelli) were performed in relatively young patients with mild-moderate degenerative articular changes. Since the main goal of such procedures was to delay the progression of the illness and relieve the symptoms as well, we have observed that in our case series of 1124 patients submitted to Chiari osteotomy, 134 (12%) of those patients underwent a subsequent total hip replacement. The implant of the prostheses in such population is definitely more technically demanding due to the cotyle modification (bone stock, shape, anterior and posterior deficient contour, abnormal centre of rotation). Recently computer assisted surgery might help at least the acetabular implant even if the experience of the chief surgeon cannot be undervalued.