Bombelli's valgus-extension osteotomy for osteoarthritis due to acetabular dysplasia: results at 10 to 14 years |
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Authors: | Toshikazu Kubo Mikihiro Fujioka Shoichi Yamazoe Keiichiro Ueshima Shigehiro Inoue Motoyuki Horii Kenichi Ando Ryo Imai Yasusuke Hirasawa |
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Institution: | (1) Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan, JP;(2) Department of Orthopaedic Surgery, Fujita Health University School of Medicine, Toyoake, Japan, JP;(3) Department of Orthopaedic Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan, JP |
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Abstract: | Severe osteoarthritis due to acetabular dysplasia (n = 17) was treated with valgus-extension osteotomy, and the patients' clinical outcomes 10–14 years after operation were evaluated
according to clinical factors (Japanese Orthopaedic Association hip score; JOA score) and by roentgenography. The mean JOA
score 10 years or later had improved by 22 points compared with the preoperative score. On roentgenography, joints which had
preoperative roof osteophyte had better postoperative formation of roof osteophyte. The JOA score was higher in the 12 joints
which had osteophyte 5 mm or longer than in those joints with osteophyte that was 5 mm or shorter. Postoperative joint space
widening occurred in 15 joints (88.2%) 3–6 months postoperatively, and it reached the maximum at 3–5 years. In patients who
had a large bone cyst in the femoral head preoperatively, the cyst collapsed, and deformation of femoral head occurred after
operation, but remodeling of the joint surface occurred naturally and the congruity improved. In the 6 joints in which the
preoperative acetabular head index was less than 60% and the acetabular angle was larger than 30°, the JOA score at 10 years
or later was lower than that of the other joints. Based on these findings, valgus-extension osteotomy was evaluated as a useful
surgical method for advanced or terminal osteoarthritis in young or middle-aged patients. Predictive factors for long-term
prognosis would be the preoperative length of roof osteophyte, joint space widening, and the degree of femoral head covering.
Received: December 1, 1999 / Accepted: May 29, 2000 |
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Keywords: | Osteoarthritis Acetabular dysplasia Bombelli's osteotomy Valgus-extension |
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