Institutional members access full text with Ovid®

Share this article on:

Long-term Results of the Dial Osteotomy in the Treatment of High-grade Acetabular Dysplasia.

Miller, Nancy H MD*; Krishnan, S G MD†; Kamaric, Emir MS‡; Noble, Philip C PHD

Clinical Orthopaedics & Related Research: April 2005 - Volume 433 - Issue - pp 115-123
doi: 10.1097/01.blo.0000153992.17554.67

The dial osteotomy, an acetabular reorientation procedure based on radiographs, was developed by R. H. Eppright for treatment of hip dysplasia; however, long-term results are not recorded. The aim of this study was to evaluate retrospectively the results of the dial osteotomy as done in 37 patients (44 hips) at an average followup of 12.6 years. Articular pressures with the application of a time and pressure algorithm were calculated from radiographs to correlate calculated intraarticular pressures with progression of degenerative disease. Clinical results at followup were 32 (73%) satisfactory and 12 (27%) unsatisfactory hips. Six (13%) hips failed between 10-20 years (average 14.7 years). A satisfactory result correlated with the preoperative functional score. Radiographically, the anterior center-edge angle increased from an average of 6.7° to 37.9°. At followup, radiographic indices of degeneration indicated that eight (18%) hips had improved, 18 (41%) had stabilized, and 18 (41%) had deteriorated. Severin indices improved in 21 (48%) hips. Joint space width at followup provided the only correlation between radiographic parameters and clinical result. Contact pressures were reduced from 4.45 MPa to 1.12 MPa. The cumulative exposure to articular pressures averaged 61.6 MPa-years, and did not correlate with radiographic parameters or clinical success.

Level of Evidence: Therapeutic study, Level IV (case series-no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.

From the *Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD; the †W.B. Carrell Memorial Clinic, Dallas, TX; ‡Intrinsic Orthopaedics, Inc., Wilmington, MA; and the §Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX.

Received: March 24, 2004

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patient/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Correspondence to: Nancy H. Miller, MD, Department of Orthopaedic Surgery, Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287. Phone: 410-955-9553; Fax: 410-502-6816; E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.