The Effectiveness Of Bernese Periacetabular Osteotomy In Treatment Of Developmental Dysplasia Of The Hip

Objective:To investigate the clinical effectiveness of the Bernese periacetabular osteotomy for adults with developmental dysplasia of the hip by modified Smith-Petersen approach.Methods: Between March 2014 and December 2015,a total of 16 hips of 16 patients with developmental dysplasia of the hip had been treated with Bernese periacetabular osteotomy by Smith-Peterson approach,and the clinical data were retrospectively analyzed.There were 1 males and 15 females with an average age of 36.9 years(range,18~ 45 years).According to the T?nnis osteoarthritis classification:5 hips were rated as Grade 0,9 hips as Grade ?,and 2 hips as Grade ?.Of which 2 cases combining with proximal femoral osteotomy and surgical hip dislocation,4 cases combining with surgical hip dislocation.We had made the analysis about these Harris hip scores,Harris pain scores,visual analogue scale scores,lateral center-edge angle,anterior center-edge angle,acetabular index angle,ROM,hospital stays,blood loss,operative time and complications which were collected from each patient.Results: All 16 patients were followed up which the mean follow-up period were 29months(range,15~35 months).The average operation time was 3.2 hours(range,2.5~6.3hours);the average intraoperative blood loss was 650 ml(range,400 ~ 1600 ml);Postoperatively,8 cases accepted blood transfusion and the average amount of blood transfusion was 400 ml(200 ~ 600 ml);the postoperative average drainage volume was 108.5 ml(50~200 ml);and the average hospitalization time was 14.3 days(8~28 d).At last follow-up,the mean Harris hip scores was improved from(77.00±13.56)points preoperatively to(92.25±4.86)points postoperatively,which the mean hip Harris pain scores was improved from(30.63 ± 7.72)points preoperatively to(42.00 ± 4.79)points postoperatively;the mean VAS scores was improved from(4.96 ± 1.32)points preoperatively to(0.31 ±0.70)points postoperatively;the mean lateral center-edge angle was increased from(4.30±8.50)°preoperatively to(30.02±5.82)°;postoperatively,the mean anterior center-edge angle was increased from(7.53 ± 3.62)° preoperatively to (28.80 ± 4.63)° postoperatively;the mean acetabular index angle was decreased from(28.08±5.72)°preoperatively to(3.04±1.26)° postoperatively.Shenton line was not consecutive in 16 patients preoperatively,and in 5 patients postoperatively.At last follow-up,pain of 12 hips disappeared,pain of 4 hips significantly relieved,the average hip ROM decreased of patients.Conclusions: Bernese periacetabular osteotomy is an effective method,and abtain satisfactoury early treatment outcome which can correct femoral head coverage obviously,it may prevent the progression of osteoarthritis hopefully.