Total hip arthroplasty of dysplastic hip after previous Chiari pelvic osteotomy.
BACKGROUND
Many reports have suggested that Chiari pelvic osteotomy would improve the results of acetabular component placement and fixation in subsequent total hip arthroplasty. However, little is known concerning the biomechanical, radiological, and clinical effects of Chiari pelvic osteotomy on subsequent total hip arthroplasty.


METHODS
Ten total hip arthroplasties for developmental dysplasia of the hip after previous Chiari pelvic osteotomy (Chiari group) were compared with 20 total hip arthroplasties for developmental dysplasia of the hip without previous surgery (control group). Preoperative patient demographic data and operative technique were well matched between the groups. The mean duration of follow-up was 3.0 years. Biomechanical, radiological, and clinical evaluations were performed.


RESULTS
No acetabular or femoral components exhibited loosening. All patients had good or excellent clinical score according to the Merle d'Aubigne-Postel rating system at the most recent follow-up. Abductor force and joint force were smaller in the Chiari group, although long operative time, more blood loss, and verticalization of joint force were noted in this group.


CONCLUSIONS
This limited study suggested that Chiari pelvic osteotomy changed the biomechanical features of the hip joint, and that this alteration might have compromised subsequent total hip arthroplasty.
Minoda
Yukihide
Y
Department of Orthopaedic Surgery, Suita Municipal Hospital, 2-13-20 Katayama-cho, Suita, Osaka 564-0082, Japan. yminoda@msic.med.osaka-cu.ac.jp
Kadowaki
Toru
T
Kim
Mitsunari
M
D019644:Arthroplasty, Replacement, Hip; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy; D010384:Pelvic Bones / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation