Slotted acetabular augmentation in the treatment of painful residual dysplastic hips in adolescents and young adults.
OBJECTIVE
This study retrospectively evaluated the benefits and prognostic factors of slotted acetabular augmentation (SAA) used for treating painful residual or neglected dysplastic hips in adolescents and young adults.


METHODS
Sixteen hips in 15 patients underwent SAA at an average age of 14.4 years. The radiologic and functional outcomes were reviewed after an average follow-up of 6.6 years.


RESULTS
All the patients obtained marked alleviation of pain (p<0.05). Harris hip score (HHS) was improved from 74.7 to 92.7 on average (p<0.05). Postoperative center-edge angle, Sharp's angle, c/b ratio and femoral head coverage showed significant improvement (p<0.01). Among the radiographic parameters, only the postoperative measurement of the femoral head coverage was significantly correlated with improvement of HHS (p<0.05). Detectable progression of osteoarthritis, from grade III to IV, was found in one patient 12 years after surgery. None of the hips required conversion to joint replacement. There were no surgical complications. Three-dimensional computed tomography showed that the grafts remained intact and provided congruent coverage at the latest follow-up, and none of them required arthroplasty.


CONCLUSIONS
The major benefit of SAA was to alleviate hip pain by increasing load-bearing area. This benefit was not sensitive to preoperative radiographic parameters. There were no postoperative complications. Compared with other complex reconstructive acetabuloplasty procedures, SAA is a simple, safe and effective pain-reducing procedure for symptomatic dysplastic hips in adolescents and young adults.
Su
Yu-Ping
YP
Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, and Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Wang
Matthew N H
MN
Chang
Wei-Ning
WN
D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D010146:Pain; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult