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Periacetabular Osteotomy for Containment of the Nonarthritic Dysplastic Hip Secondary to Poliomyelitis

Sierra, Rafael J. MD; Schoeniger, S. Ralf MD; Millis, Michael MD; Ganz, Reinhold MD

Journal of Bone & Joint Surgery - American Volume: 15 December 2010 - Volume 92 - Issue 18 - p 2917–2923
doi: 10.2106/JBJS.I.00753
Scientific Articles

Background: Poliomyelitis results in a flaccid paralysis of muscles that can lead to hip instability. The objective of this study was to determine the results of the Bernese periacetabular osteotomy in patients with paralytic hips secondary to poliomyelitis.

Methods: Nine patients who had a Bernese periacetabular osteotomy were identified as having paralytic hip dysplasia secondary to poliomyelitis. All patients had hip pain and instability at the time of presentation. Clinical records and radiographs were reviewed. One patient did not return for physical examination at last follow-up.

Results: The mean length of follow-up was 103 months. All patients had a decrease in the severity of pain but less improvement in function, as hip abductor muscle strength was improved in only two of the eight patients examined. The average postoperative Harris hip score was 80.2. All patients had an improvement in the extrusion index, the acetabular index, and the lateral center-edge angle. According to the Tönnis radiographic classification, three patients progressed from Grade 0 to Grade 1 and one patient progressed from Grade 1 to 2.

Conclusions: The correction obtained with use of the Bernese periacetabular osteotomy provides containment of the hip joint in patients with hip dysplasia secondary to poliomyelitis. The patients had a decrease in the severity of pain and less improvement in function. The results have been long-lasting and may have slowed the progression of osteoarthritis of the hip.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

1Department of Orthopedics, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address: sierra.rafael@mayo.edu

2Department of Orthopedic Surgery, Spitalzentrum Emmental, Oberburg Strasse 43, 3400 Burgdorf, Switzerland

3Department of Orthopaedic Surgery, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115

4Orthopedic Department, Inselspital University of Bern, 3010 Bern, Switzerland

Copyright 2010 by The Journal of Bone and Joint Surgery, Incorporated
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