title: Shelf acetabuloplasty in the treatment of severe Legg-Calvé-Perthes disease: good outcomes at midterm follow-up.
abstract: The aim of the study was to retrospectively review results of operative treatment for coverage deficit of femoral head in children with severe epiphysis displacement in Legg-Calvé-Perthes (LCP) disease. The material included 23 shelf acetabuloplasty procedures for LCP disease. The average age at diagnosis was 8.1 years (range 4-12). Mean follow-up was 5.8 years (range from 2.2 to 11.2 years). Mean Reimer's index decreased statistically significantly from a mean of 32% before surgery to 10.0% at the last follow-up (P < 0.00001). The mean Wiberg center-edge angle increased also statistically significantly from a mean of 17.3° before procedure to 32.3° at the last follow-up (P < 0.00001). According to the Stulberg classification, type I was observed in 2, type II in 13, type III in 6, and type IV in 2 hips. There were no differences in the range of motion or leg length discrepancy in preoperative and postoperative standing. Partial, not significant, bone graft resorption was noted in 6 cases in the first 6-9 months after surgery. To conclude, shelf acetabuloplasty allows achieving good midterm results in the treatment of severe stages of LCP disease. The procedure improves coverage of femoral head and allows its remodelling.
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Łódź, ul. Drewnowska 75, 91-002 Łódź, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Grzegorzewski
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Łódź, ul. Drewnowska 75, 91-002 Łódź, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Synder
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Łódź, ul. Drewnowska 75, 91-002 Łódź, Poland.
authors.forename: Krysztof
authors.initials: K
authors.lastname: Kmieć
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Łódź, ul. Drewnowska 75, 91-002 Łódź, Poland.
authors.forename: Karol
authors.initials: K
authors.lastname: Krajewski
authors.affiliation: Department of Angiology, Medical University of Łódź, ul. Narutowicza 60, 90-136 Łódź, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Polguj
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Łódź, ul. Drewnowska 75, 91-002 Łódź, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Sibiński
mesh_terms: D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000473:pathology / Q000601:surgery*; D005260:Female; D005270:Femur Head / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000473:pathology / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D016896:Treatment Outcome