title: Factors associated with an unfavourable outcome after Salter innominate osteotomy in patients with unilateral developmental dysplasia of the hip: does occult dysplasia of the contralateral hip affect the outcome?
abstract: Salter innominate osteotomy is an effective reconstructive procedure for the treatment of developmental dysplasia of the hip (DDH), but some children have a poor outcome at skeletal maturity. In order to investigate factors associated with an unfavourable outcome, we assessed the development of the contralateral hip. We retrospectively reviewed 46 patients who underwent a unilateral Salter osteotomy at between five and seven years of age, with a mean follow-up of 10.3 years (7 to 20). The patients were divided into three groups according to the centre-edge angle (CEA) of the contralateral hip at skeletal maturity: normal (> 25°, 22 patients), borderline (20° to 25°, 17 patients) and dysplastic (< 20°, 7 patients). The CEA of the affected hip was measured pre-operatively, at eight to nine years of age, at 11 to 12 years of age and at skeletal maturity. The CEA of the affected hip was significantly smaller in the borderline and dysplastic groups at 11 and 12 years of age (p = 0.012) and at skeletal maturity (p = 0.017) than in the normal group. Severin group III was seen in two (11.8%) and four hips (57.1%) of the borderline and dysplastic groups, respectively (p < 0.001). Limited individual development of the acetabulum was associated with an unfavourable outcome following Salter osteotomy.
authors.affiliation: Department of Rehabilitation, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kaneko
authors.affiliation: Department of Rehabilitation, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kitoh
authors.affiliation: Department of Rehabilitation, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mishima
authors.affiliation: Department of Rehabilitation, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Matsushita
authors.affiliation: Department of Rehabilitation, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Kadono
authors.affiliation: Department of Rehabilitation, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Ishiguro
authors.affiliation: Aichi Children's Health and Medical Center, Department of Orthopaedic Surgery, 1-2 Osakada, Morioka-Cho, Obu, Aichi 474-8710, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hattori
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006617:Hip Dislocation / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Acetabular development; Developmental dysplasia of the hip; Occult dysplasia of the contralateral hip; Salter innominate osteotomy